DEPARTMENT OF THE INTERIOR 
BUREAU OF EDUCATION 



BULLETIN. 1918. No. 10 



PUBLIC SCHOOL CLASSES FOR 
CRIPPLED CHILDREN 



BY 

EDITH REEVES SOLENBERGER 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1918 



V^OTiO 



igrap^ 



BULLETIN OF THE BTJrvEAlT OF EDUCATION. 

jfoTB. — With the exceptions indicated, the doc^-'onts named belov.* -vviU be sent fre« 
of charsc upon n;j;)llcp.llon to the Commissioner r.f Education, Washington, D. C. Those 
marked with an asterisk ^*) are no lonper available for free distribution, but may be 
had of the Superintendent of Documents, (Jcvernment Printing Office, Washington, D. C, 
upon payment of the price stated. Remlttanr.cs should be made iu eola, currency, or 
money order. Stamps are not accepted. 

A complete list of available publications wlJl be sent upon application. 

1917. 

*No. 1. Monthly record of a-.rront educational publications, January, 1917. 

5 cts. 
*No. 2. Reorganization of Eii'.clish in secondary schools. A report of the Com- 
mission on Secondary Kducation. James F. Hosic. 20 cts. 
*Na 3. Pine-needle basketry in schools, William C. A. Hamniel. 5 cts. 

No. 4. Secondary agricultural schools in lUissia. AV. S Jesien. 
*No. 5. Report of an Inquiry into the administration aud .support of the Colo- 
rado school system. Katherine M. Cook and A. C. Monahan. 10 cts. 

No. 6. Educative and economic possibilities of school-directed home gardening 
in Richnwnd, Ind. J. L. Randall. 

No. 7. Monthly record of current educational publications, February, 1917. 

No, 8. Current practice in city school administration. W. S. Deffenbaugh. 

No. 9. Department-store education. Helen R. Norton. 

No. 10. Development of arithmetic as a school subject. W. S. Monroe. 

No. 11. Higher technical education in foreign countries. A. T. Smith and 
"W. S. Jesien. 

No. 12. Monthly record of current educational publications, March, 1917. 

No. 13. Monthly record of current educational publications, April, 1917. 
*No. 14. A graphic survey of book publication, 1890-1916. F. E. Woodward, 
5 cts. 

No. 15. Studies in higher education iu Ireland and Wales. Geo. E. MacLean. 

No. 16. Studies in higher education in England and Scotland. Geo. E. Mac- 
Lean. 

No. 17. Accredited higher institutions. S. P. Capen. 
*No. 18. History of public-school education in Delaware. S. B. Weeks. 20 cts. 

No. 19. Report of a survey of the University of Nevada. 

No. 20. Work of school children during out-of-school hours. C. D. Jarvls. 

No. 21. Monthly record of current educational publications, May, 1917. 

No. 22. Money value of education. A. C. Ellis. 
•No. 23. Three short courses in home making, Carrie A. Lyford. 15 cts. 

No. 24. Monthly record of current educational publications — Index, February, 
1916-January, 1917. 

No. 25, Military training of youths of school age in foreign countries. 
W. S. Jesien, 

No. 26, Garden clubs in the schools of Englewood, N. J. Charles O. Smith, 

No. 27, Training of teachers of mathematics for secondary schools. R. C. 
Archibald. 

No. 28. Monthly record of current educational publications, June, 1917. 

No. 29. Practice teaching for secondary school-teachers. A. R. Mead. 

No. 30, School extension statistics, 1915-16, Clarence A. Perry. 

No. 31. Rural-teacher preparation in county training schools and high schools. 
H, W, Foght, 

No. 32. Work of the Bureau of Education for the natives of Alaska, 1915-16. 
[Continued en page 3 of corer,] 



DEPARTMENT OF THE INTERIOR 

BUREAU OF EDUCATION 



BULLETIN, 1918, No. 10 



PUBLIC SCHOOL CLASSES FOR 
CRIPPLED CHILDREN 



BY 



EDITH REEVES SOLENBERGER 




WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1918 



L_0 ^S3/ 

.57 



ADDITIONAL COPIES 

OJ THIS PTTBLICATION MAY BE PEOCOTtED FEOM 

THE SUPERINTENDENT OF D0CtJMENT3 

GOVERNMENT PRINTmO OFFICB 

■WASHINGTON, D. C. 

AT 

10 CENTS PEE COPY 



D. of D. 
UL 12 19t8 



CONTENTS. 



^ Page. 

Letter of transmittal 5 

Introduction 7 

History of day-school classes 9 

Admission to special classes 10 

Special buildings for cripples 12 

Equipment 14 

Transportation 16 

Food 17 

Fresh Air 18 

Sm'gical and medical supervision 19 

Hours of sessions 24 

Mental progress 25 

Discipline 27 

Classes for mentally deficient cripples 27 

Organization of classes 28 

Educational aims 29 

Provision for cripples in certain cities: 

New York 34 

Chicago 37 

Philadelphia 40 

Cleveland 42 

Detroit 43 

Baltimore 44 

Private day schools for cripples 45 

Appendix A— Suggestions to teachers in small cities and in country schools 48 

Appendix B — Record cards used in New York 49 

Appendix C — Cost of special classes in Chicago and Cleveland 52 

3 



LETTER OF TRANSMIHAL. 



Department of the Interior, 

Bureau of Education, 

Washington, December 2G, 1917. 

Sir: Although there are in the United States many thousands of 
crippled children, probably as many as there are of deaf and blind, 
little attention has been given them as a class. They are not even 
enumerated in the decennial Federal census. While special provi- 
sion for the deaf and blind children is made in all States and for 
feeble-mmded and incorrigible children in most of the States, few 
States make any special provision for the care and education of 
crippled children, and in only half a dozen cities are there separate 
schools or classes for them, and in the schools of most cities, towns, 
and rural districts not even suitable seats and desks are provided for 
them. It is therefore all the more important that what has been 
done by the public schools of the few cities that have given most 
attention to this matter be known. 

The manuscript transmitted herewith on public school classes for 
crippled children is the result of a study made at my request by 
Edith Reeves Solenberger. I recommend that it be published as a 
bulletin of the Bureau of Education. 

Respectfully submitted. 

P. P. Claxton, 

Commissioner, 
The Secretary of the Interior. 

6 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 



INTRODUCTION. 



Every child wants to be like other children. The habit of children 
over 6 years of age is to go to school. Any child who is unable to 
do so because he is physically crippled misses a great deal more than 
instruction. Many crippled children have grown up to be "queer" 
in an unnecessary degree because they have mingled so little with 
children of their own age. They have been treated in special fashion 
by their parents, sometimes harshly in ignorant homes, but more 
often with a mistaken kindness which saved the "poor cripple" of 
the family all exertion and robbed him of the ambition to develop 
such powers of mind and body as he possessed. For such children 
there is no other tonic like the give-and-take of life in the schoolroom 
and on the playground. 

Cnp2)les in regular classes. — A great many children with slight de- 
formities have always attended school in regular classes with children 
not so handicapped. People who have worked for years with crip- 
pled children say that a crippled child able to do so profits by at- 
tending school with children not crippled. For that reason the 
superintendents of institutions for crippled children sometimes send 
the stronger ones out to attend public school classes, even though 
the institution has a good school,^ 

Separate public school classes for cripples. — But the educational 
needs of many crippled children can not be met in classes attended 
by children who are physically sound. Cripples who are not able 
to go to regular classes can attend separate classes for cripples, where 
provision is made for their transportation and for their comfort and 
safety while in school. In addition to special care for the health of 
the children, these classes for cripples offer school opportunities to 
some deformed children who are very sensitive about their appear- 
ance and incapacity. They feel at ease where they find other chil- 
dren who have the same difficulties. 

Special classes for crippled children have been opened in public 
and private day schools in six of the large cities of the United States, 
namely. New York, Chicago, Philadelphia, Baltimore, Cleveland, and 
Detroit. This pamphlet will treat in detail the work of these day 

» For example, the Industrial Home for Crippled Children in Pittsburgh, 



8 PUBLIC SCnOOL CLASSES FOR CEIPPLED CHILDEEIT. 

schools, but brief mention should be made of the large amount of 
educational work done in residential institutions, some of them pri- 
vate, others maintained by the States in which they are located.^ 

Instruction in hospitals. — School work is undertaken in some hos- 
pitals where orthopedic operations are performed and children are 
kept for brief periods of recuperation. The instruction in hospitals, 
however, is always incidental to the physical cure of the children. 
It is often undertaken because a small amount of study amuses the 
children and is thought by the doctors to facilitate their cure, rather 
than because much educational advance is expected. 

In addition there are a considerable number of convalescent hos- 
pitals for crippled children, usually located in the country, where 
large numbers of crippled children live for long periods while stiU 
undergoing treatment. The State hospital schools for cripples in 
Massachusetts, New York, Nebraska, and Minnesota have large 
graded schools comparable at all points with the best public schools 
in their vicinity. There are half a dozen private residential institu- 
tions in various States with excellent graded schools. The most con- 
spicuous of these is the Widener Memorial School in Philadelphia, a 
magnificently endowed institution, where the school, like all its other 
departments, has the best possible equipment and the highest stand- 
ard of instruction. 

The grading in schools maintained by convalescent hospitals for 
children is sometimes less exact than in day schools because some of 
the children are more badly crippled. They have to drop out of 
school occasionally for operations and sometimes attend irregularly 
while taking special treatments. On the other hand, children who 
need special surgical treatments are often better able to keep up with 
their school work if they live at one of the institutions than they 
would be if they lived at home and made frequent trips to a dis- 
pensary. The institution schools include, perhaps, a larger number 
of crippled children who have never attended school before and are 
far behmd the usual grade for their age than the day school classes 
for cripples. 

Teachers sent to institutions for cripples. — In three cities the boards 
of education have sent pubhc-school teachers to private institutions 
to organize classes among the crippled patients. Most of the children 
attending these classes are able to come to a room set aside for school 
work, but individual children confined to their beds often receive 
instruction from the teachers. This cooperation between the public 
schools and the institutions for cripples has been developed most 
strikingly in Baltimore, where there is a class for cripples with a 

• Residential institutions for crippled children in the United States were visited by the writer in the 
course of a study made for the llusscU Sage Foundation of New York. A detailed description of the 
work of 37 hospitals, convalescent hospitals, and asylum homes will be found in the Foundation's volume, 
f'Care and Education of Crippled Children," by Edith Reeves 



\ 



PUBLIC SCHOOL CLASSES TOR CRIPPLED CHILDREN. 9 

public-school teacher in each of the three institutions for crippled 
children, the Kernan Hospital and Industrial School for Crippled 
Children, the Children's Hospital School, and the Johns Hopldns 
Hospital School and Convalescent Home for Crippled Children 
(colored). In Pliiladelpliia one pubhc-school teacher is assigned to 
the Orthopedic Hospital. In Chicago one public-school teacher is 
assigned to the Home for Destitute Crippled Children, which is 
located near the Spalding School for Cripples. Most of the 25 pupils 
at tiie institution are bed cases and the teacher's work is individual 
instruction. 

HISTORY OF DAY-SCHOOL CLASSES.^ 

Tlie liistory of day-school classes for cripples in America shows in 
several cities a gradual transition from private to public responsi- 
bility. Any city board of education may usually be persuaded to 
provide a teacher for crippled children on the ground that if they 
were not crippled they would certainly have a right to instruction in 
the public schools and teachers would have to be furnished for them. 
The provision of special seats and other accommodations wliich 
make crippled children more comfortable is usually the next step, 
since it is simply an extension of the school's usual custom in pro- 
viding equipment for classrooms. The two special items of expense 
which a city usually undertakes last are the transportation of cripples 
in busses, and the provision of free lunches. 

The best illustration of this development is the work in Cleveland, 
Ohio. The assistant superintendent, Mr. Henry C. Muckley, writes: 

Our school for cripples is the culmination of a process of evolution. It began with 
an organization of women known as the Sunbeam Circle, who gathered together a 
few crippled children in a school and furnished for them a teacher. The next step 
in the evolution was that the board of education furnished the teacher. Then the 
board of education built a suitable building to accommodate these children. Mean- 
while, the Sunbeam Circle transported them fi'om their homes to the school and back 
again. This function is now performed by the board of education. The Sunbeam 
Circle still continued to furnish, lunches for the children; now the board of education 
furnishes everything, the children's lunches, transportation, general equipment, etc. 
In other words, the school for cripples is a part of our organization. 

Chicago, Detroit, and Baltimore, like Cleveland, provide without 
cost everything needed by the crippled cliildren, including lunches 
and transportation. In Philadelphia all expenses are borne by the 
city except the lunches, wliich are still supplied by private charity. 

In New York the city first provided instruction and equipment for 
cripples in separate classes and their transportation was privately 
furnished. Then the city contracted for a gradually increasing num- 
ber of busses, and the remaining busses were supphed by the Asso- 

' The first public-school classes for cripples ia the United States were opened in Chicago in 1899. 
Similar classes were opened in New York in 1906; in Detroit in 1910; in Cleveland in 1910; in Philadel- 
phia and Baltimore in 1913. 



10 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN". 

elation for the Aid of Crippled CliUdren for many years. At present 
that association maintains only two busses, while the city furnishes 
40. Lunches are sold to crippled children in New York for very 
small sums, and charitable associations contribute toward the cost 
of the food in some cases. 

One city, Grand Rapids, IMich., has begun its work for crippled 
children in an unusual way. Crippled children are transported to 
and from school in busses maintained by the city, but separate 
classes for crippled children have not yet been organized. 

ADMISSION TO SPECIAL CLASSES. 

The admission of children into separate classes for cripples in the 
public schools is determined by different tests in the various cities. 
The assistant superintendent of schools in Cleveland says of their 
special school: 

Not all crippled children are admitted, of course. In our definition, a crippled 
child is a child that can not help himself to school. Many children are cripples who 
go to regular school. 

This test is a practicable one so long as exceptions are made in 
particular cases. The vast majority of children in each class for 
cripples must be transported to school. There are sometimes, how- 
ever, a very small number of children living close to the school for 
cripples and able to walk, and possibly a few able to use the street 
cars, who are, nevertheless, better able to attend a class specially 
equipped for cripples than they are to go to a regular classroom. 
Children unable to walk at all are seldom admitted to public- 
school classes because they require more help than teachers or 
matrons have time to give. Final decision as to whether or not a 
crippled child needs the facilities of a special class is usually left to 
the orthopedic surgeon who diagnoses the child's physical difficulty 
and is best able to judge his capacity. The very complete record 
cards used in New York schools^ require the surgeon to state whether 
or not the child is able to attend school and also whether or not he 
should be in a separate class for crippled children. 

The actual procedure by which a child is admitted to a special 
class for cripples is fundamentally the same in the different cities. It 
is given as follows for the Cleveland School for Cripples : 

Pupils are admitted to this school upon recommendation of the Department of 
Medical Supervision. The initial step, however, is usually taken by the parents of 
the children themselves, who, knowing that there is a school of this kind to which 
children are sent, are glad to have their crippled children avail themselves of this 
pri\dlege. They usually notify the school directly and the principal informs the 
medical department of the fact that the child is asking admission. An investigation 
is made and the admission of the child is recommended to the assistant superintendent 
having that school in charge; he approves and the transfer is made. 

'See Appendix p 49. 



PUBLIC SCHOOL CLASSES FOR CKIPPLED CHILDREN. H 

WHY THE CHILDREN ARE CRIPPLED. 

It is important that every teacher of crippled children should have 
an elementary knowledge of the different physical difficulties which 
have caused them to become crippled. In a limited space it is im- 
possible to enumerate all the different causes which give children 
handicaps, but mention will be made of some of the frequent types 
of cases. 

Infantile paralysis has been within recent years the best-known 
cause of crippling among children. The epidemic which included so 
many children during the summer of 1916 will probably increase the 
proportion of paralysis cases among crippled children in public 
schools. When these children come to school they have no active 
disease whatsoever, and their general health is often excellent, but 
they have Httle or no use of one or both hands, or one or both legs, 
or, very often, are unable to use one hand and one leg. The building 
up of their paralyzed muscles is an exceedingly slow process, but 
surprisingly good results have been obtained by many months or 
years of special gymnastics and massage. Operative measures are 
sometimes employed also. Most of the children whose legs have 
been affected by paralysis come to the public schools wearing braces; 
a few with limbs badly paralyzed are confined to wheel chairs. They 
are very hopeful objects of a teacher's attention, for they can safely 
be urged to study as earnestly as any other children. They often 
constitute the bulk of the enrollment in a class for crippled children, 
and they usually stay in the special classes for a good many years 
before they are able to go to regular classes. Many of them are 
never able to attend school except in special classes for cripples. 

Other causes. — For purposes of instruction we may class with the 
chi'dren who have had infantile paralysis those whose limbs have 
become twisted through rickets or certain inflammatory diseases, 
those who have lost one or more limbs as a result of accidents, and the 
small number of children born deformed. All of these children may 
be perfectly sound as to their general health and able to do excellent 
work in school, although they can not walk well nor, in some cases, 
use their hands efficiently. 

Bone tuberculosis. — Special consideration in some ways must be given 
by the teacher to those children who have or have had bone tubercu- 
losis, usually of the spine or of the hip joint. Some of these children 
come to school wearing braces, but many of them have the diseased 
joint or spine held firm by a jacket of plaster of Paris. In regard to 
children with bone tuberculosis, there is sharp difference of opinion 
among surgeons as to whether they should attend public schools. 
Some orthopedic surgeons believe that all children with active bone 
tuberculosis should be in country convalescent hospital schools, where 
their physical condition may be under constant medical supervision. 



12 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREF. 

Others believe that some such children can safely live at home and 
attend special classes for cripples in the pubUc schools if their parents 
and the visiting nurses from the hospitals see to it that they report 
frequently at the hospital dispensaries for treatment. When these 
children do come to the pubUc schools they must be surrounded by 
the best of conditions for their general health. They have special 
need of fresh air and nourishing food. They must be carefully 
watched; while exercising, to prevent overexertion. 

Many children who have had bone tuberculosis have entirely re- 
covered from the disease, although they are deformed. They may, 
therefore, be classed as pupils with the children who are paralyzed, 
congenitally deformed, etc., rather than with those who have active 
tuberculosis, with this important difference: Any child who has ever 
had bone tuberculosis should be surrounded by the very best condi- 
tions for his general health in order to prevent the return of the 
disease or the beginning of lung tuberculosis in later years. 

Classification of defects. — The proportion of children with each 
type of physical defect varies from school to school. Of the children 
attending the Spalding School in Chicago in 1915-16, 50 per cent 
were partially paralyzed, the majority as a result of infantile paraly- 
sis; 25 per cent were classified as bone tuberculosis cases; the other 
25 per cent included those crippled by inflammatory diseases and by 
accident, and those congenitally deformed. In New York City about 
one-third of all the cripples in attendance in the special classes for 
cripples are classified as having active bone tuberculosis.^ 

In New York City, crippled children with bone tuberculosis have 
been segregated into separate classes in six different public schools 
where there are several classes for cripples in the building. We shall 
discuss further the special needs of crippled pupils who have bone 
tuberculosis later in this bulletin when taking up the subject of 
supervision of the health of the children in classes for cripples.^ 

SPECIAL BUILDINGS FOR CRIPPLES. 

Most of the classes for cripples are very likely to include children 
of all the foregoing physical types. The provisions for their comfort 
and safety in the public schools are, therefore, in most of the school 
buildings, such as to accommodate as well as possible aU the different 
classes of cripples. There are four day school buildings in the United 
States which were especially designed and built for the exclusive use 
of crippled children. Any board of education which plans the erec- 
tion of a school for cripples will find it profitable to send a repre- 
sentative to visit some of these buildings, or to procure copies of the 
architects' plans from which they were constructed. 

> Seo Rep. Supt. Schools, New York, 1914-15, pp. 110-112. »See pp. 15 and 22. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 13 

Chicago. — The Spalding School in Chicago is the only permanent 
school building in the United States erected and maintained entirely 
by a city board of education for the exclusive use of crippled children.^ 
It is a one-story and attic building, only slightly elevated above the 
street. On the ground floor there are five classrooms, an assembly 
hall, a kitchen, dining room, nurse's room, bathroom, and rest room. 
The attic, which is reached by an incline from, the first floor, contains 
the industrial classrooms. The children in the attic rooms are pro- 
tected against accident in case of fire by specially designed fire 
escapes recently completed. An incline 100 feet long leads from 
each end of the attic directly to the ground. An addition to this 
building has been authorized by the board of education, to cost 
S82,000. It will contain four additional classrooms, three large 
industrial rooms, masseur's room, receiving room, bathroom, and a 
large sun room with glass roof. 

Cleveland. — The only other pubHc school for cripples which is 
housed in a building erected at city expense for the exclusive use of 
crippled children is the school in Cleveland. This is a one-story 
wooden building, located in a large yard at the rear of the Wilson 
School] one of the large public schools of the city. The building for 
cripples has classrooms, dining room, kitchen, and surgical dressing 
room. While the Spalding School in Chicago is an excellent model 
for cripples' schools built of stone or other permanent material, this 
smaller wooden building in Cleveland shows how well a building 
erected at much less cost can serve the needs of crippled children. 

Boston. — The Industrial School for Crippled and Deformed Chil- 
dren in Boston is a purely private day school for cripples. Its large 
building, with classrooms for 100 grade pupils and several large 
industrial workrooms, was designed especially for the use of cripples, 
and is well worth the attention of public school officials who plan the 
erection of similar buildings. 

New York. — The building occupied by the Crippled Children's 
East Side Free School in New York is privately owned, although the 
City of New York now finances the grade classes for cripples which 
are conducted there. This is the largest day school for cripples in 
America. The classrooms accommodate 200 children, and there are 
also large workrooms and a roof playground. This building and 
the Boston school have classrooms on several floors; both buildings 
have ele^'ators of unusual size which take the children from floor to 
floor in perfect safety. The stairways have broad treads at easy 
distances. 

Special rooms for crippled children. — By far the greater number of 
crippled children attending special public-school classes for cripples 

1 Plans have been drawn for a permanent building in Detroit. 



14 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN". 

arc taught in rooms set aside for them in large school buildings 
whore there are also many classes for children who are not crippled. 
This is true of all the classes in public-school buildings in Philadel- 
phia, Baltimore, and Detroit, one of the two pubhc schools for 
cripples in Chicago, and all the classes in New York except those in 
the Crippled Children's East Side Free School. In all these cities 
the crippled children are always given the best rooms in each build- 
ing, located on the first floor, so that the children will not need to 
climb staii-s. Wherever possible, the crippled children have been 
assigned to rooms with a sunny exposure, because it is recognized 
that cheerful smToundings affect the spirits of the children, as well 
as because sunny rooms are more healthful. Basement rooms are 
not used, although they could sometimes be reached without the 
use of steps and would in that respect be superior to first-floor 
rooms. It has been found better to have the children helped up 
the steps to the first floor by the attendant or driver of the stage 
which brings them to school than to give them basement rooms, 
because the latter usuaUy have poorer light and air and are more 
likely to be damp, cold, and noisy. 

Architectural features. — ^The rooms for crippled children are so 
located that as many easy exits as possible are available for use in 
case of fire. Thresholds are usuaUy absent altogether, because they 
would cause a child with crutches or a brace to stumble. It is 
important also to have wide aisles in schoolrooms for crippled chil- 
dren. If the aisles are narrow the crippled child who walks along 
them is likely to stumble over the extended feet of seated children 
who are wearing braces. Where the school can afford such provision, 
strips of rubber or cork are laid on hall floors and stairs, and similar 
material is sometimes used for covering entire floors of gymnasiums 
and playrooms. In a few buildings, one of them the school in Cleve- 
land, there are handrails along the walls at low levels by which 
paralyzed children or others who can not walk well help themselves 
along. Toilets and lavatories are conveniently located. The toilet 
seats are either of varying heights or all so low as to be convenient 
for the smaller children and those who are most crippled. 

EQUIPMENT. 

Adjustable seats and deslcs. — In the schoolrooms adjustable seats 
and desks are usually provided. Sometimes the seats are so con- 
structed that one or both sides can be dropped in case the child using 
the scat has one or both legs held straight by brace or plaster; while 
the backs can be adjusted at any angle and the seat raised or lowered 
at will. The desks which go with these elaborate seats are also 
adjustable as to height, and the top of the desk can be moved back- 
ward and forward. This special equipment is somewhat expensive. 
One set costs usually from SI 7 to $19. Other schools use desks and 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 15 

seats which can be adjusted as to height, and seats with one central 
support instead of two side supports, so that there may be more room 
for a child whose legs are encumbered by apparatus. Many teachers 
believe that these partially adjustable desks and seats are entirely 
satisfactory for the greater number of crippled children, and a half 
dozen of the more costly drop seats is a sufficient number in the 
average schoolroom. At the Massachusetts Hospital school the 
desks and seats are not fastened to the floor, because it has been 
found that a child is sometimes able to take a more comfortable 
position through a slight change in the position of the desk or seat. 

There are even a few teachers who are entirely satisfied with 
ordinary nonadjustable desks and seats like those used in some 
public schoolrooms. They say that the children take positions 
which they find comfortable, and that the ordinary equipment is 
quite satisfactory when seats and desks of varying heights are pro- 
vided, so that each child may have the size to which he can best 
adapt himself. It is the writer's conclusion after visiting practically 
all the schools for cripples in America, both day schools and those in 
institutions, that the semiadjustable desks and seats are distmctly 
better for all crippled children than those which can not be adjusted 
at all, and that at least half a dozen of the specially adjustable seats 
should be furnished in each classroom for cripples if the necessary 
expense can be met. 

Special equipment. — Special seats and desks are the chief items of 
expense in equipping a schoolroom for use by crippled children. 
Some schools have in addition a small number of, wheel chairs for 
use by paralyzed children who can not sit comfortably in any other 
kind of seat. In most schools a few couches or sanitary cots are 
provided upon which the children may lie down for rest periods. 

Special equipment is particularly necessary for a class composed 
entirely of crippled children who have active tubercidosis. The 
equipment ordered for such a class in Public School 69 in New York 
is recommended for similar classes: 

1. Adjustable seats and desks, also air cushions, to make more comfortable seating 
for some children. 

2. Sanitary iron couches with washable canvas stretchers and air pillows, for use 
during rest periods. 

3. New model folding chair planned by the New York department of physir-al 
training for tubercular hip cases, or for other children who can not lie upon the couches 
comfortably. 

4 . Blankets and sweaters for use during rest periods in cold weather. 

liandwor-k equipment. — Finally, a school for cripples must have 
more tlian the ordinary amount of equipment and supplies for hand- 
work. Many of the classrooms have small looms for making rugs ; all 
of them have liberal provision for work with paper, yam, raffia, and 
reed, and cloth for sewing classes. Any school which midertakes 



16 PUBLIC SCHOOL CLASSES FOE CRIPPLED CHILDREN". 

special trade classes for older cliildreii requires, of course, a much 
gi-eater expenditure for tools and machinery and for working ma- 
terials. 

TRANSPORTATION. 

Aside from these details of architecture and equipment, two other 
special provisions, always necessary in connection with day schools 
for crippled children, are among the largest items of expense in such 
schools; namely, the busses which brbig the children to school in the 
morning and take them home at night, usually accompanied by a 
nurse or a second man attendant in addition to the driver, and, 
secondly, the food served free or for very smaU payments at most of 
the day schools. 

The crippled children are transported to and from their homes and 
the schools by omnibuses which travel along carefully planned routes 
so laid out that each bus gathers children from its section of the city 
with as little waste travel as possible. Horse-drawn omnibuses 
were first employed to transfer crippled children in most of the cities, 
and are stiU used m Philadelphia, m Cleveland, and to some extent 
in New York. In some cases the work was begun with ordinary 
carriages. But motor omnibuses are gradually replacing the horse 
vehicles. Motor busses are preferred because they make much faster 
time. For that reason they can cover a wider area and bring children 
from greater distances. Each bus can usually make several trips 
before and after school, and the children taken on each trip reach 
their destination much more quickly than they did in the horse- 
drawn busses. The children enjoy their rides to and from school, 
but it is not desirable that the journey should be more than three- 
quarters of an hour in length if that can be avoided, smce some of 
the children become too weary if they sit long at a time. The motor 
busses are more easily warmed, also, and therefore better in cold 
weather than Horse busses. 

In several cities the busses are provided by private owners who are 
paid by the city under contract. In Chicago, Detroit, and Balti- 
more the children are transported in police-patrol automobiles. In 
Baltimore the patrols used for the crippled children are marked 
"School Ambulance." The report of the New York superintendent 
of schools for 1915-16 (pp. 95-96) recommends that the city should 
purchase outright several motor busses with removable seats and 
cushions. These busses could be used not only for the transportation 
of crippled children to and from school but for their transportation 
to hospitals for treatment. On Saturdays and during vacation 
periods the seats and cushions could be removed and the busses 
could be used for ordinary transportation of supplies. 

Drivers and attendants. — Each stage has a driver and an attendant 
able to hft the more helpless children. These attendants are some- 



BUREAU OF EDUCATION 



BULLETIN, 1918, NO. 10 PLATE 2 




A. NEW ENGLAND PEABODY HOME FOR CRIPPLED CHILDREN, HYDE PARK, 

MASS. 




B. INDUSTRIAL SCHOOL FOR CRIPPLED AND DEFORMED CHILDREN, BOSTON, 

MASS. 



BUREAU OF EDUCATION 



BULLETIN, 1918, NO. 10 PLATE 3 




A. OMNIBUS USED FOR TRANSPORTING CRIPPLED CHILDREN, NEW YORK. 




Ji. ADJUSTABLE SEAT AND DESK USED IN SPECIAL CLASSES FOR CRIPPLES IN 
PUBLIC SCHOOLS OF NEW YORK. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 17 

times women but more often men. In several cases police officers 
liave been employed. When the attendant is a woman the driver 
is expected to help to carry the larger children. In New York City 
the 28 stages furnished by the city have men attendants. The 
stages provided by the Association for the Aid of Crippled Children 
are accompanied by women nurses. The special teacher in charge 
of physically handicapped children urges the superiority of women 
attendants. She says: 

The contract (to supply stage service paid for by the city) should also require the 
presence of a woman attendant in the stage instead of men or boys. In stages having 
women attendants results have been very satisfactory in the improved conduct of 
the children during transportation, in securing home care for the children, and in 
improved attendance. It would be a valuable addition to the home inspection if 
nurses from the board of health could be assigned to this work. 

The use of men as attendants has thus far been in most cases a 
matter of convenience. Patrolmen have been assigned to this work 
in cities where children are transported in pohce-patrol wagons because 
this could be done without the expense of extra employees. 

FOOD. 

The second large item of expense in separate classes for cripples is 
the food served free or for very small payments. Hot lunches are 
usually given to the children at noon, consisting of a hot soup or stew, 
bread, cocoa, or milk, and a simple pudding. One or more vegetables 
are sometimes added. In many classes milk or milk and crackers 
are served when the children reach school or in the middle of the 
morning. In Chicago, Cleveland, Detroit, and Baltimore the food is 
furnished entirely free by the city. In New York and Pliiladelphia 
the bulk of the expense is met by private contributions, and the 
children make small payments if they are able to do so. For example, 
in Public School 107, in New York, soup was served for 3 cents, and 
sandwiches, cookies, cocoa, milk, etc., for 1 cent each. The children 
there are required to take the soup before they are allowed to have 
sweets. In some schools, where cripples buy food in the regular 
school lunch rooms used by all children in the building, the crippled 
children are served first. 

A special study of the school lunch menu for crippled children in 
the public schools in New York was made in 1915-16. It was found 
that the children ate too much white bread, white crackers, and 
macaroni, and too many sweets. A change in the menu was urged, 
in order to include more food containing the mineral elements which 
are needed by all children, but especially by those cripples who have 
bone tuberculosis. 

Nourishing food is part of a public school's provision of conditions 
which foster the physical well-being of children in the cripples' classes. 
46486°— 18 2 



18 PUBLIC SCHOOL CLASSES FOK CRIPPLED CHILDKElT. 

FRESH AIR. 

Fresh air is another element which is desirable for all children, 
but of especial importance for children who have been ill and who 
need to gain as much strength as they can from every source. Any 
visitor to classrooms for crippled children will note that the air is 
purer than in most public-school rooms for normal children. This 
is especially true in schools which are supervised or visited by physi- 
cians, because they generally order open windows. The air in a 
number of classrooms visited seemed as pure as that out of doors, 
even during cold weather. This result was attributed to open 
windows rather than to a system of indirect ventilation. During 
the winter a plentiful supply of steam is furnished in most of the 
schools where the windows are kept open, and the children are 
expected to wear their outdoor wraps on the coldest days. 

Outdoor classrooms. — None of the public day schools for cripples 
have special rooms or buildings designed for the use of outdoor 
classes. Several of the residential institutions conduct outdoor 
classes in special rooms whose arrangement may be mentioned here 
as of possible suggestive value for public schools. At the Massachu- 
setts Hospital school outdoor classes are held on open platforms 
adjoining the school building, which forms the only solid wall. On 
the other three sides there is a tight board railing -about 3 feet in 
height, with pillars at intervals which are connected overhead to 
the main building by rods, over which an awning can be drawn. The 
children sit in collapsible boxlike chairs with very high backs 
extending to the floor behind their feet, and with winged pieces of 
board at each side to break the wind. Very warm clothing, knit 
caps, and heavy blankets are provided. 

The first specially designed building for outdoor school work for 
crippled children was completed about 1914 at the Industrial School 
for Crippled and Deformed Children in Boston. This building, 
erected at a cost of S15,000, has a substantial roof and one brick wall; 
the other three sides have steel pillars covered with concrete, between 
which there are sHding glass partitions. In order to obtain ventila- 
tion without a draft through the room, the roof is built in monitor 
form with movable windows in two sections. The seats used are 
similar in general design to those at the Massachusetts Hospital 
school. There are also half a dozen canvas cots which stand along 
the sunny southern side of the building and are used during rest 
periods. 

A simpler outdoor school building was built at about the same time 
»t the Sewickley Fresh-Air Home, near Pittsburgh. This building 
is roofed, but has no walls; glass partitions are used in winter. 

These are the only institutions where school classes can be held out 
of doors throughout the year, but mention should be made of the 



PUBLIC SCHOOL CLASSEo FOR CRIPPLED CHILDREN. 19 

excellent arrangement at Sea Breeze Hospital at Coney Island, N. Y., 
for outdoor teaching during about half the year. From early spring 
until late in the fall the school classes there are held in a tent with 
wooden floor and board walls about 3 feet high. The walls are com- 
pleted above that height by screens and canvas which may be dropped 
in case of rain. 

Outdoor classes v. open windows. — The importance of fresh air for 
crippled children, especially for those with bone tuberculosis, can not 
be overemphasized. But there are differences of opinion as to the 
best methods for obtaming the fresh air. At the meeting of the 
Federation of Associations for Cripples in New York City in April, 
1913, there was a discussion of outdoor schoolrooms and schoolrooms 
where windows are kept open in winter, which brought out sharp 
differences of opinion as to whether or not cold temperatures have a 
bad effect upon the children's physical condition. Many of the 
physicians seemed to agree that cold in itself was never harmful if 
the children were warmly dressed and had plenty of good food. But 
many physicians advise a reasonable degree of warmth in school- 
rooms, especially those used by crippled children who have bone 
tuberculosis, and advocate schoolrooms with plenty of window space 
rather than outdoor rooms where little or no heat is provided. Better 
progress is usually made educationally when the children are warm 
enough to avoid the need of heavy wraps and are able to use their 
hands for writing. 

It must not be forgotten that the effect upon the children's health 
can not be foretold from a knowledge of the mere facilities for securing 
fresh air unless one knows also how those facihties are used. An 
apparently old-fashioned building may be well ventilated if the indi- 
vidual teachers see to it that windows are lowered from the top and 
raised from the bottom in sufficient measure to obtain a good supply 
of fresh air. On the other hand, a room with the most approved 
movable walls will not have good air if these be not removed during 
the school sessions. The Crippled Children's East Side Free School 
of New York is noteworthy among day schools because its windows 
are actually kept open throughout the year. The fresh air and the 
nourishing food which are desirable for all cliildren have been dis- 
cussed here because they are specially needed by crippled children. 
These children need also much special attention for their health 
which is not necessary for other children. 

SURGICAL AND MEDICAL SUPERVISION. 

Most of the crippled children attending public school classes for 
cripples are or should be under the supervision of an orthopedic 
surgeon; they should report frequently at the hospital dispensary, 
where their surgeon can examine them. The relation of the bchool 



20 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 

to the surgical and medical treatment of the crippled children varies 
widely in the different cities. 

At one extreme, the Crippled Children's East Side Free School in 
New York, at the expense of a private organization, offers to the 
children taught by public-school teachers in that building practically 
all phases of surgical and medical care for their orthopedic difficulties 
except operations requiring an anesthetic. A visiting orthopedic 
surgeon holds weekly clinics at the school building, where an assistant 
surgeon and a trained nurse assist him in the adjustment of braces, 
application of plaster dressings, and other treatments. Under the 
supervision of a staff of nurse maids, all the children have baths at 
the school twice each week. There were 9,703 baths recorded for 
one school year, and 450 visits were paid to the homes of the children. 

PhiladelpJiia. — At the other extreme, the public school classes in 
Philadelphia have no orthopedic surgeons of their own and no nurses 
with special orthopedic training. This does not mean that the 
children in the Philadelphia classes are less well looked after from 
a medical point of view than those in other public schools. The 
difference is simply one of organization. Philadelphia is noted for 
its many fine hospitals, and the schools cooperate with the social 
service departments in the various hospitals. The school nurse 
has general supervision of the cripples, as of other children, and a 
matron is provided in each school where there are cripples to super- 
intend the serving of their lunches and to act as attendant for children 
who can not go from one room to another without some help. 

In all the six cities with public school classes for cripples, the 
children are either inspected by an orthopedic surgeon at the school 
or urged to attend the hospital dispensaries. A nurse or matron is 
sometimes present in the classroom all the time that the children are 
there; in other schools a trained nurse with special Imowledge of 
orthopedics gives part of her time to work at the school and part 
of her time to visiting the children in their homes. Special gymnastic 
exercises adapted to crippled children are given in most of the classes, 
sometimes by the class teachers and sometimes by special teachers 
of g3minastics. There are so many differences between the detailed 
methods used in different cities that we shall state here briefly the 
system of medical supervision in each city. 

New York. — The City of New York has had since 1907 a special 
supervising teacher assigned to the classes for cripples by the director 
of physical training for the public schools of the city. Under her 
supervision the grade teachers have learned to watch carefully 
the health of their pupils. The ph3^sical activities of every child in 
the special classes for cripples are limited carefully in accordance with 
the recommendations of special hospital record cards kept at the 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN". 21 

school.* These cards were originated by the department of physical 
training of the pubhc schools of New York in order that each child's 
orthopedic surgeon himself might state the disease, treatment, and 
physical care he desired for the child. The cards show the exact 
nature of the child's disease or deformity and indicate which physical 
exercises are regarded by the surgeon as desirable, and just what 
kinds of exercise the child in question must not undertake. The card 
index also shows whether or not the child should be allowed to climb 
stairs. These cards are renewed once each year for all pupils who 
are under hospital supervision and once each term for all cases of 
bone tuberculosis. They are also renewed after any long absence 
from school, after any change in a child's brace or cast, and after any 
surgical operation. Every effort is made to keep the child's record 
on these hospital cards up to date. 

Except at the Crippled Children's East Side Free School, where, as 
stated before, orthopedic supervision is provided by a private organi- 
zation, the New York schools do not attempt surgical or medical 
measures at the schools. It is the endeavor of the schools to cooperate 
as intelligently as possible with the large orthopedic hospitals in the 
city whose dispensaries provide adequate supervision for all crippled 
children. Visiting nurses from these hospitals are largely responsible 
for seeing to it that the children actually come to the dispensaries 
when ordered by their surgeons and that directions are carried out 
by the parents at home. The teachers in the schools have given 
valuable cooperation in securing the interest of the children and their 
parents in the child's treatment at the hospital. The Association 
for the Aid of Crippled Children, a private society, has for many j^ears 
initiated movements in behalf of crippled children in New York, and 
has aided great numbers of individuals. 

The New York teachers have not only cooperated with the surgeons 
in charge of children who were already under treatment when they 
entered the public schools, but they have also persuaded the parents 
of many children not under treatment to take them to orthopedic 
dispensaries. The report of the New York schools for 1915-16 states 
(p. 114) that in some classes for cripples only 10 to 20 per cent of the 
children were under treatment when the classes were organized. In 
the same classes there are now 90 to 95 per cent of the children under 
orthopedic treatment regularly at various clinics. When one class 
for cripples was organized in Brooklyn, only 15 per cent of the 
children were receiving medical attention. The superintendent 
reports (1914-15) that every child in the class is under medical 
supervision. This cooperation on the part of the teachers should 
receive special commendation when we remember that it has meant 

>See appendix, p. 49. 



22 PUBLIC SCHOOL classes for CEIPPLED CHILDREN". 

frequent visits on their part to the homes of the children and some- 
times to the hospitals in order to arrange for the child's visits to the 
dispensary. 

Within the last two years New York has undertaken the segrega- 
tion of crippled children with bone tuberculosis into separate classes 
in all of the school buildings where there are several classes for 
cripples. Such classes have been organized thus far in six different 
public schools. These classes are located in large rooms with southern 
exposure and open window ventilation, with a temperature in wmter 
kept between 50 and 60 degrees. In addition to hot lunches at noon, 
the children have special feeding, both in the morning and just before 
startmg for their homes in the busses at the close of the school day. 
The formation of these classes has been followed by very beneficial 
results. A teacher in one of the classes kept careful records of the 
children's physical improvement. One month after the formation 
of the class every child except one had gained in weight. At the 
end of seven months all had gained in weight except two children 
who needed hospital care. 

Children are not admitted to the special classes for cripples in 
New York unless they can walk well enough to look after them- 
selves. It is recognized that there are in a large city like New York 
many crippled children living at home who are not able to walk 
but who are mentally bright and would profit by instruction. The 
superintendent's report for 1915-16 recommends the appointment 
of special visiting teachers who will be assigned to the instruction of 
crippled children in their own homes. While awaiting the city's 
action, the Association of Public School Teachers for Cripples in 
New York is trying to meet the need by providing volunteer teachers 
and by appealing for contributions which wiU enable one or two 
teachers to give their entire time to the work. 

Cliicago. — The schools for cripples in Chicago have always empha- 
sized strongly the physical care of the children. This is especially 
true of the larger of the two schools, the Spalding School. The 
principal of this school states in her report for 1915-16: 

The policy of the school is to take in all crippled children who apply, even though 
the deformity may be very slight, so that advice and assistance may be given parents 
in obtaining proper treatment. The first aim of the school is to improve the physical 
condition of the children. The actual school work gives place always to this. 

The teachers in the school are required by the board of education 
to take a special course of study concerning the diseases, treatment, 
and care of crippled children, and a course in industrial work suited 
to cripples. They are able to cooperate intelligently with the special 
teachers who give curative gymnastics to the children. 

For many years the children attended daily chnics at the adjoin- 
ing Home for Destitute Crippled Children, an orthopedic hospital. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREIiT. 23 

An important change has been made durmg the past year. The 
entire care of the physical condition of the chikh-en has been taken 
over by the new Municipal Tuberculosis Sanitarium of Chicago, 
which has enlarged its field in order to care for all the crippled chil- 
dren whether or not the cause of their condition is bone tuberculosis. 

The sanitarium furnishes to the school a nurse and medical sup- 
plies, arranges for operations and treatment, and takes the children 
to clinics. Complete files are kept, in which there is a social and 
physical history of each child. At the Spalding School itself, the 
children have thorough physical examinations frequently, daily 
dressing of sinuses, massage and curative gymnastics, and baths for 
medical purposes. The board of education has recently installed 
dental equipment at a cost of S500 and the board of health gives the 
services of a dentist. An oculist from the board of health also 
visits the school. 

Cleveland. — The children who attend the school for cripples in 
Cleveland were very carefully supervised until a year and a half 
ago by a visiting nurse with special orthopedic training who was 
furnished jointly by Lakeside Hospital and Rainbow Cottage, a 
country convalescent children's hospital. At present the school 
children are examined only by the regular school nurse, but the 
former system had some merits so striking that we mention it here, 
although it is not now in force. The orthopedic nurse represented 
three Imks in a chain which offered all kinds of service for crippled 
children except asylum care. The employment by the three organ- 
izations, the hospital, the convalescent hospital, and the public 
school, of the same nurse or nurses had the very great advantage of 
permitting the nurse to follow individual children through every 
period of their care. She usually met a child first at the hospital 
dispensary. She visited his home and urged the mother to follow 
out the doctor's orders and to revisit the dispensary at the time set 
by the doctor. Later, she watched the child's progress at hospital 
or convalescent hospital. After he was able to leave the institu- 
tion she visited him at home and at school. She renewed dressings 
and adjusted braces at the school itself and kept so closely in touch 
with the child's condition that she was always ready to suggest 
further hospital treatment if that seemed necessary. 

A teacher of physical culture, employed by the board of education, 
comes to the school three times a week. She gives massage to the 
paralysis cases and teaches the waitresses to assist her in this work; 
she also superintends special gymnastic exercises which are conducted 
by the teachers on days when she is not there. 

Detroit. — In Detroit an orthopedic surgeon, appointed by the 
board of health, examines all children applying for admission to the 
classes for cripples, and visits the school at intervals to examine the 



24 PUBLIC SCHOOL CLASSES FOE CRIPPLED CHILDEEN. 

pupils and perform small operations. The special school nuise is on 
duty for five hom's every school day; she gives massage and electric 
treatments. The Detroit Association for the Aid of Sick and Crippled 
Children supphes crutches and braces to all pupils in need of such help. 

Baltimore. — The children in special classes for cripples held in 
public school buildings in Baltimore attend dispensaries connected 
with the city's hospitals, and visiting nurses from the hospitals keep 
constant watch over their physical condition. The teachers and the 
visiting nurses work together to secm'e the conditions v^hich are best 
for the improvement of the children's health. 

It will be noted that there is a great difference between the different 
cities in regard to how much of the physical supervision of the 
children is done by the school and how much is done by visiting 
nurses from hospitals or from other outside agencies. In any city 
where special classes for crippled children are being organized for 
the first time, the board of education will find it an advantage for 
the health of the children, as weU as a saving financially, to make use 
of all the agencies which already exist for the care of crippled children. 
If there is a good hospital with an out-patient department and visit- 
ing nurses, the school will probably have no need of a specially 
trained orthopedic nurse. On the other hand, ii the city has no 
hospital with an orthopedic department, a nurse who is a graduate of 
a training school connected with an orthopedic hospital would be of 
the highest service if she were engaged by the board of education to 
look after the children at the school, under the direction of their, 
doctors, and to visit their homes. Where children who are almost 
helpless are admitted to the public schools, a matron or attendant 
is necessary. If such children are not admitted, they must stay at 
home and a visiting teacher is a Go'd-send in the midst of their 
monotonous lives. 

HOURS OF SESSIONS. 

The hom's of the sessions are shorter for the cripples' classes than 
for other school classes in practically all the pubhc schools. In 
Detroit the hours are identical with those in other public-school classes 
in the spring and fall, but from November until April the classes for 
cripples begin an hour later in the morning, so that the children need 
not leave their homes so early in cold weather. The sessions are 
from 9.30 to 3 in Cleveland. In other cities the classes for cripples 
are in session from 9 until 2 throughout the school year, with an 
intermission for lunch which is often extended beyond the hour 
given to children who are not crippled. 

Rest periods. — There is considerably more variety and elasticity of 
schedule in special classes for crippled children than in regular public- 
school classes. The children are permitted to leave their work and 
lie down for short periods when they are tired, sometimes in a separate 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 25 

rest room provided for the purpose, sometimes on a couch in the 
corner of the schoolroom. In some classes, notably the newly organ- 
ized special classes for children with bone tuberculosis in New York, 
all children in the class are required to lie down for rest after their 
noon meal. Individual children whose strength is limited are some- 
times required to rest at regular intervals, as ordered by a surgeon, 
the nurse, or the teacher. 

MENTAL PROGRESS. 

The average observer would expect to find the educational progress 
of crippled children much slower than that of other children because 
of the short sessions and liberal rest periods, as well as on account of 
the weakened vitahty of some of the children. It is true that the 
majority of children in classes for cripples are behind other children 
of their age, but this is very often due to the fact that they did not 
enter school until they were considerably past the regular age, 
rather than because their progress has been slow since they began 
work in the special classes for cripples. The difficulties under which 
some of the crippled children labor, especially those who still have 
active bone tuberculosis, must not be minimized. Yet the average 
observer wiU be amazed to find when visiting special classes for 
cripples how large a proportion of the children are able to do genu- 
inely good work and to move from grade to grade as rapidly as other 
children. This fact is attributed by the teachers to two causes. 

Classes are small. — In the first place, each child in a special class 
for cripples receives considerably more individual attention than it 
is possible for one child to receive in an ordinary grade classroom 
in the pubhc schools of a city, because the classes for cripples are 
^very much smaller, often not more than half as large as other classes 
in the same building. The average number of children in special 
classes for cripples for the six cities is about 20. In New York City 
20 is the maximum number allowed, although that number is slightly 
exceeded at times when the pressure for admission of two or three 
more children is very great. Twelve is the minimum number v.dth 
which a class may be organized in New York. The average number 
per teacher in Cliicago is somewhat under 25. At the Spalding 
School there are 11 teachers for regular class work with 200 children. 
The average number in each classroom in the Cleveland school for 
cripples is about 22. In Detroit the number of pupils per teacher 
at any one time is not often greater than 23. In Philadelphia from 
20 to 25 children are usually enrolled with each teacher, and an 
average attendance of about 18 per teacher is maintained. In 
Baltimore the two classes .for cripples held in public-school buildings 
had an average membership for 1915-16 of 15 and 16 children, 
respectively, and an average attendance for each class of 14. Classes 



26 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 



for children who are not crippled in all these cities are often very 
much larger than they should be for the best interests of the children, 
because the boards of education find it impossible to finance the 
schools upon the basis of small classes. It is much to the credit of 
the educational authorities that they have seen the necessity of a 
smaller number of pupils per teacher in the cripples' classes. Each 
crippled child can be carefully studied as an individual by the teacher 
and given special instruction in branches which the child finds most 
difficult. 

It is interesting to note in this connection the number of pupils to 
each teacher in the schools for cripples in London. The following 
figures\are quoted from an article by Douglas C. McMurtrie, reprinted 
from the New York Medical Journal, dated January 25, 1913: 

Schools for cripples iri London. 



1906 



1907 



1908 



Number of teachers 

Number of pupils 

Average number of pupils to each teacher 



66 
1,547 
23.4 



90 
2,045 
22.7 



93 
2,392 
25.7 



107 

2,544 
23.8 



Cripples often earnest students. — The second reason for the excellent 
progress made by many crippled children is the character of the 
children themselves. Many of them are so limited in their interests 
by the fact that they can not walk well or play running games with 
other children that they concentrate their attention upon their 
school work with unusually keen interest. The hours spent in school 
are often the brightest in their restricted fives. They undertake each 
task earnestly and work with a thoughtfulness and perseverance 
which can not fail to bring rapid progress. Many children who have 
spent considerable time in a hospital or under treatment while at 
home undertake school work for the first time with a zest which is 
largely due to an unconscious rejoicing that they are for the first 
time Uke other children because they can go to school. 

Wide differences. — The teacher of crippled children has to deal with 
a far more compUcated situation than the teacher in an ordinary 
class. Each of her pupils is likely to vary greatly from time to time 
in energy and capacity, according to his physical health. Some of 
the children lose time for operations or during special treatments and 
are irregular in attendance. Furthermore, there is tremendously 
more variation between the different pupils than between a similar 
number of ordinary children. Some of the children in a special class 
for cripples are famihar with pubUc-school routine and have much 
the same point of view as normal pupils. This is especially true 
of children who had infantile paral3^3is at the age of 8 or 10 or later, 
after several years of attendance at pubHc schools in ordinary classes 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREIS". 27 

when they were themselves entirely healthy and strong. On the other 
hand, a large number of the crippled children in these special classes 
have never been able to attend regular schools or to associate freely 
with other children. This is very often true of those who have 
bone tuberculosis and of children congenitally deformed or paralyzed 
when very young. The teacher must, therefore, be able to face the 
problems of children accustomed to school work and of other children 
to whom the atmosphere of the schoolroom is an entirely new thing. 
It is not intended to suggest that crippled children can be divided 
accuratel}' into the two groups mentioned. The crippled child may 
differ greatly or to only a slight extent from the normal sound child 
of his own age in general strength and in point of view. The grada- 
tions are many between, for example, a boy who was a vigorous 
urchin until he lost a leg in a trolley accident at 12 or 13 and, on 
the other hand, a child who has been paralyzed from the age of 3 or 
4, or one who has been fighting to overcome bone tuberculosis suice 
an early age. 

DISCIPLINE. 

This very great variation in the children's condition and previous 
experience affects not only their instruction in the subjects taught 
in school, but their discipline. Some crippled children are unduly 
petted and looked after at home and must receive their first lessons 
in independent effort after they come to school. From the teacher 
and from fellow pupils in the class they learn for the first time that 
a crippled child who tries to be like other children is happier and 
more successful than one who is too easily content to occupy a special 
and peculiar niche in the world. There are other crippled children 
of the timid, shrinking kind who have been in rare cases abusively 
treated at home or, more often, have been unduly teased and re- 
minded of their deformities by thoughtless children on the street and 
elsewhere. The teacher's sympathy and inspiration will go far to- 
ward encouraging them and inducing pride in some line of achieve- 
ment in which they may learn to excel and thus forget the handi- 
caps for which they have been ridiculed. 

CLASSES FOR MENTALLY DEFICIENT CRIPPLES. 

A very special problem is presented by children who are both 
pliysically crippled and in some measure deficient mentally. Pro- 
nounced cases should, of course, be sent to institutions, but most of 
tlie cities which have public-school classes for cripples find some of 
Iho children retarded mentally. 

New Yorlc. — In New York City an effort is being made to segre- 
gate such children into special classes of their own. During the year 
1915-16 there were three such classes. The special supervisor of 
cripples' classes recommends that these segregated classes with doubly 



28 PUBLIC scnooL classes for ceippled children. 

Imndicappcd children be retained in the public schools, but that those 
children who prove themselves unable to benefit at all by the edu- 
cational facilities provided should after reasonable trial be sent to 
an institution under the supervision of the department of education. 
Philadelphia. — In two of the schools which have classes for crip- 
ples in Philadelphia the children who are dull or subnormal are 
put into one class, usually with some bright children, since there are 
hardly enough retarded cases to constitute an entire class. It is 
worth noting that at the McCall School the teacher of the class which 
includes subnormal pupils has been specially trained for this pur- 
pose by a course at the institution in Vineland, N. J., and by long 
experience in charge of a private home school for feeble-minded 
children. 

ORGANIZATION OF CLASSES. 

There is an unexpected resemblance to the old-fashioned country 
district school on the part of many of the classes for crippled children, 
although these classes are all located in large cities. This is due to 
the fact that, wherever there is only one special class for cripples in 
a building, it must offer work in any or all of the eight grammar 
grades which the children admitted are ready to enter. In some of 
the classes visited the work was not carried beyond the sixth grade, 
because none of the children were able to do higher work. 

Wherever there are several classrooms for crippled childi-en in 
one building the work can be graded more accurately and each 
teacher given certain definite grades. This is true in both of the 
schools for cripples in Chicago, the school in Cl.eveland, and that in 
Detroit. In each of the three public schools in Philadelphia which 
have classes for cripples there are two or three classrooms set aside 
for them, and the grades are divided between these classrooms. In 
Baltimore there is but a single class in each school, and the work 
of many grades must be offered in one room. In New York City 
there are seven schools which have only one class for cripples in the 
building^ together with many regular classes for children who are 
not crippled. Tavo, thi-ee, four, and five classes for cripples each 
occur in two schools. Finally, one school, the Crippled Children's 
East Side Free School, has 11 classes for cripples, the largest number 
taught in one building in any school in the United States. In this 
school each teacher has the work of a single grade, as she would have 
in any city class for cliildren not crippled. This is true also of the 
Spalding School in Chicago, and of the private day school in Boston, 
the Industrial School for Crippled and Deformed Childi-en. 

Where it is possible to include at least two or tlu-ee classes for 
cripples in a single building the work of each teacher is very much 
easier, and the children make more rapid progress in their studies. 
It is, of course, only in a very large city, like New York, Chicago, or 



PUBLIC SCHOOL CLASSES FOE CRIPPLED CHILDREN. 29 

Boston, that a school for cripples ^^dll have pupils enough to require 
a teacher for each grade. But in smaller cities when classes for 
cripples are organized it is well to put at least two classes in one 
building if possible and use motor busses in order to bring this larger 
number of children from greater distances. 

Flexibility in grading. — The special classes for cripples, whether 
there are several grades in a given school building or only one, 
usually show som.ewhat greater flexibility in the grading of the pupils 
and in their promotion than do other public school classes. The 
most extreme case of this flexible grading is found not in any public 
school, but in the Massachusetts Hospital school for cripples at 
Canton, Mass. The report of this school for 1912 states, on page 16: 
"Promotions are made freely from group to group at any time during 
the year when a pupil shows evidence of ability to do the work of 
the class next above." It is possible that this end may be attained 
in good measure in the public schools for cripples in future years. 

EDUCATIONAL AIMS. 

Some of the problems which must be solved in the teaching of a 
class of cripples are produced by the fact that both curable and in- 
curable crippled children are usually included in the same class. 
A large proportion of crippled children can be cured, or so far helped 
that in the course of time they will be able to reenter regular classes 
in the public schools. These temporarily crippled children find in 
the special classes much needed opportunity to keep up with their 
school work in so far as their physical condition permits. Some of 
them are able to return to the regular public school classes after only 
a year in a special class for cripples. It is important that the curric- 
ulum in a class including such children should resemble as closely 
as possible that in regular public school classes in order that the 
temporarily crippled children may return to regular classes with as 
little break as possible in their school career. As a matter of fact, in 
all the classes for cripples there is a remarkable resemblance between 
the subjects studied and methods of instruction used and those in 
ordinary public school classes. The assistant superintendent of 
schools in Cleveland summarizes the course of instruction as follows: 

The work in this school is about the same as we are doing in other schools: Keading 
spelling, writing, arithmetic, geography, history, sewing, drawing, molding simple 
objects, kindergarten work, music, and gymnastics. Our aim is to make these 
children feel that they are doing what children ordinarily do, and living the natural 
hfe. 

This statement could be very nearly duplicated as true of the pub- 
lic school classes for cripples in the other cities. 

It is usually the ambition of a teacher of crippled cliUdren to be 
able to say that the children who leave her class after they are cured* 



30 PUBLIC SCHOOL CLASSES FOll CRIPPLED CHILDREN. 

reenter regular public-school classes in the grades which would have 
been theirs if they had remained perfectly well. This ambition is 
very commonly reahzcd. It is a pleasure to record the success of the 
efficient and painstaking efforts made by teachers of crippled children 
in all the special classes to fit their curable pupils for return to regular 
classes. 

But there are also considerable numbers of crippled children whose 
cure is impossible, or possible only after many years of treatment. 
Tlicy may be entirely free from disease, but some degree of deformity 
is permanent. In many schools these children represent a large 
majority of the total enrollment. They need a complete system of 
education in special classes, because they will never be able to attend 
regular schools which will develop such powers as they possess. 

No liigh schools for cn%>iAes. — It is unfortunate that there are as 
yet no special high schools for cripples in the United States and no 
high-school buildings with any classrooms offering the accommoda- 
tions needed by crippled children. The only hopeful exception is 
the Spalding School in Chicago, a graded school for cripples, where a 
class was organized in September, 1916, with nine cripples who were 
graduates of the eighth grade, for the purpose of instructing them in 
some liigh-school branches. Some crippled children do go to high 
school if their physical condition is sufficiently improved, but a very 
liigh proportion of the crippled children attending special classes are 
unable to go beyond the grammar grades because the high schools 
offer no free transportation by stage and the buildings, often without 
elevators, have classrooms on several floors which are not equipped 
^\^th special seats or desks. It is to be hoped that in the course of 
time high schools for cripples may be established in the largest cities, 
or, at least, that some high-school branches may be taught in every 
city, as in Chicago, in connection with one or more of the schools 
having grade classes for cripples. 

Training for intellectual pursuits. — The fact that permanently 
crippled children have not usually been able to look forward to higher 
education is particularly unfortunate because their physical defects 
usually make them poor competitors in manual pursuits with young 
people of sound phj^sique after they leave school. If every crippled 
child with good mentality could be trained for a career which made 
small demand upon his physical capacity but required considerable 
mental training, we should be maldng the greatest possible use of our 
handicapped citizens. People interested in the career of a particular 
crippled child should give him a high degree of training for some 
so-called "intellectual" pursuit, if he has the abihty and if the money 
to meet the cost of such training can be secured. 

Manual occupations. — The majority of crippled children, Uke the 
majority of other cliildren in great cities, can not look forward to 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 31 

higher education. The greatest service wliich it is possible for the 
schools to give these children is the provision of some general educa- 
tion plus trade training for a manual occupation which they can 
pursue with the least possible risk of physical harm. Tliis fact has 
been understood sufTiciently well wherever there are special classes 
for cripples and has resulted in the introduction into the school work 
for cripples of an unusual amount of handwork. The children are 
specially fond of tliis work, and those who are unable to enjoy active 
games, because their legs are crippled, often develop remarkal)le 
skill in all kinds of hand processes. The younger crippled cliildren 
do a good deal of cutting and weaving, which calls for training of the 
hand and eye. In addition to the usual hand processes ^vith paper 
and raffia, creditable work has been done in many classes by some of 
the older children in knitting, crocheting, making of simple cotton 
garments, and rug maldng. 

Detroit. — In Detroit several of the older boys have gone for one day 
each week to another public-school building having special courses in 
manual training. A class in millinery was taught at the cripples' 
school in 1915-16. 

PJiiladelphia. — At the Meade School, in Philadelphia, eight children 
are doing good work in rug weaving on the one loom which has thus 
far been provided. Two looms could probably be kept busy. The 
older cliildren in this school have also made creditable hammocks. 

Cleveland. — The girls receive thorough training in sev/ing. The 
older ^irls are able to make dresses for themselves. Other hand- 
crafts taught are basketry, weaving, and the making of simple toys 
and pottery. 

Baltimore. — The handwork in classes for cripples in Baltimore 
includes basketry and simple rug weaving. At the Kernan Hospital 
school near Baltimore, a public-school teaclier has charge of the grade 
instruction, while a special teacher of handwork and industrial hand- 
craft is employed by the institution. Good work is done in sewing, 
lace making, rug weaving, basketry, chair caning, burnt woodwork, 
stenography and typewriting. At the Children's Hospital School in 
Baltimore, a teacher from the Playground Association, half of whose 
salary is assumed by the hospital school, teaches advanced kinder- 
garten work, basketry, and chair caning. 

New YorTc. — In New York City there is great variation between 
the different schools in regard to the amount of handwork and simple 
industrial processes taught. The school superintendents all report 
the children's eagerness to make things with their hands. The prin- 
cipals of the schools where the least provision is made for such teach- 
ing urge the undertaking of more handwork instruction.^ At Pubhc 
School 15, Brooklyn, the children have made raffia baskets, done 

« See Report of Superintendent of Schools of New York for 1915-16, pp. 78, 80, 81. 



32 rUBLIC SCHOOL CLASSES FOB CEIPPLED CHILDBEN". 

embroidery and plain sewing, including the making of some complete 
garments, and woven small rugs. 

At a meeting of the Association of Public School Teachers of Crip- 
pled Children in New York, on March 10, 1916, a committee was 
appointed to draw up a course of study with special reference to in- 
dustrial and vocational subjects for crippled children. This com- 
mittee reported in favor of a course of study which would offer 
needlework, including plain and fancy sewing, dressmaking, embroid- 
ery, knitting and crocheting, and novelty work. They also advised 
the introduction of a course in drawing and design to include the fol- 
lowing subjects: Costume and textile design, commercial design, 
lettering and poster design, interior decorating, design in its relation 
to domestic art. 

Cliicago. — A large amount of handwork has always been done at 
the Spalding School in Chicago, and since January 1, 1916, special 
attention has been given to industrial work. At that time new 
equipment was added and new courses offered. The children in the 
fourth and fifth grades have a total of 1 hour and 50 minutes of 
work in the shop each week. Those in the sixth, seventh, and eighth 
grades have 75 minutes daily in industrial classes. The younger 
children have made toys and doU furniture after completing the 
regular kindergarten processes of cutting paper, weaving, etc. Older 
children have manual training work, sewing, crocheting, lace making, 
basketry, cooking, printing, block printing, cobbling, weaving, special 
training in designing and free hand lettering, making of artificial 
flowers, typewriting, and bookkeeping. 

The school has excellent equipment for teaching printing, including 
one very large press. This work is taught to both boys and girls, 
beginning with the sixth grade. The most successful results have been 
attained with Christmas cards designed by the children, printed in the 
printing room, and then returned to the art classes for decoration. 
It is beheved that some of the children will be able to earn their living 
later by this work. A graduate of the school, a young man who has 
no use of his lower limbs, is running a commercial printing establish- 
ment with two large motor presses and other modern equipment, all 
purchased through his own efforts. The only instruction he ever 
received was at the Spalding School. 

A $50 outfit for cobbling, sufficient to keep six boys at work, was 
presented to the school in June, 1915. Since then, the children's 
shoes have been kept in good repair by the boys' work. Equipment 
has recently been purchased which is to be loaned to any boys who 
wish to make the experiment of starting cobbling shops in their own 
neighborhoods. A graduate of the school in June, 1917, is earning 
$10 a week in the fine shoe-repairing department of one of the largest 
stores in Chicago. It is believed that a maximum of $30 a week can 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 33 

bo earned in this trade. Motor-driven equipment costing about $150 
has recently been ordered for the cobbling department. It is be- 
lieved that this work offers? an especially good opportunity for boys 
who have lost the use of both lower limbs but who arc able to be 
about on crutches. 

The school has 6 large foot looms and 10 hand looms, and good 
work in weaving has been done since February, 1916. Several of the 
looms v/ere loaned during the summer t o children who are confined to 
wheel chairs. A gift of SlOO was made to the school in June, 1916, 
for the express purpose of buying looms or other equipment to be 
given or loaned to such children. The teacher of weaving has had 
special training for this work. The teachers believe that weaving is. 
a very good occupation for ono-armed pupils. 

A graduate who left the school in February, 1915, has an appren- 
ticeship in engraving with one of the best engraving firms in Chicago. 
Two other graduates have office positions, and one is making artificial 
flowers. 

The highest development of handwork and industrial training is 
found in the two large private day schools for cripples, the Industrial 
School for Crippled and Deformed Children in Boston, and the 
Crippled Children's East Side Free School in New York. Their in- 
dustrial classes are mentioned in detail in Part II of this Bulletin, 
pp. 45, 46. Any board of education which contemplates the establish- 
ment of industrial trade classes for cripples should visit these schools 
which have been pioneers in this direction. 

Trade training. — The problem of trade training is bound to be the 
outstanding feature of future discussions concerning the education 
of crippled children, both because the establishment of industrial 
classes is the natural outgrowth of the excellent graded class work 
which has already been established in six large cities, and because 
the entrance of America into the great war has brought before us the 
problem of the reeducation and trade training of crippled soldiers. 
In choosing occupations for which soldiers crippled in different ways 
can be trained and in selecting methods of instruction, the agencies 
for the reeducation of crippled soldiers in European countries have 
profited greatly by the experience of trade classes for crippled chil- 
dren, many of which were organized a great many years before the 
war. In some cases crippled soldiers have been taught together 
with the crippled children in their trade classes. The public sym- 
pathy with the efforts of crippled soldiers to fit themselves for self- 
support will quicken the interest in the problems of all cripples. It 
is probable that there will be a rapid development within the next 
few years of public-school classes for cripples and of special indus- 
trial classes for their occupational training. 
4648G°--18 3 



PROVISION FOR CRIPPLES IN CERTAIN CITIES.^ 



NEW YORK. 



Statistics. — The City of New York lias 46 special classes for physi- 
cally crippled children, located in 16 different public-school buildings 
in various parts of Manhattan, The Bronx, and Brooklyn. In 
seven schools there is but one class for cripples in the building, 
together with many regular classes for children who are not crippled. 
Two, tlu'ee, four, and five classes for cripples each occur in two 
schools. Finally, one school has 11 classes for cripples, the largest 
number taught in one building in any school in the United States. 
This school, unlike any of the others in New York, occupies a building 
especially designed for the use of crippled children and given over to 
them exclusively.- These 46 classes have a total register of 918 
crippled children and an average attendance of 693. The smallest 
number with which a class may be organized is 12, and 20 is the 
intended maximum for one class, though that number has been 
exceeded in several cases because of the great number of applicants. 

The principal of a school whose one class for cripples had 32 
enrolled in 1914-15 stated his objections thus:^ "At present, with 32 
on register and but 20 sittings, the pupils in excess are compelled 
to use ordinary chairs and tables. The result is that the room is 
overcrowded with furnitm'e, and the pupils, who are compelled to 
use the chairs, become overtired.'' The fact that the average attend- 
ance for this class of 32 is 24 must in some measure lessen the diffi- 
culties. 

Buildings. — The 16 public-school buildings in which the classes for 
cripples are located include several of the newest and finest schools in 
New York. Some of the other schools with cripples' classes are older 
and less perfectly adapted for the use of handicapped children. In 
old and new buildings ahke the crippled children are always ^iven 
the best rooms in the school. Special desks and seats are used in 
great numbers, and other needed ecj[uipment has been Mberally 
provided. 

' The following summaries have been prepared for convenient reference. They include data already 
given in this bulletin, together with some other points of special interest iu coanectioa with the classes 
in each particular city. 

-This building docs not belong to the city but to a private organization, the Crippled Children's East 
Side Free School, which formerly financed the school entirely and which still maintains industrial classes 
and work rooms in the building. 

•Kep. of Supt. of Schools, New York, 1914-15, p. 107. 
34 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 35 

Transportation. — ^Provision is made for the transportation of crip- 
pled children between their homes and the schoolhouse by 42 stages, 
of which 40 are furnished by the city and two by a private society, 
the Association for the Aid of Crippled Children. A driver and an at- 
tendant, able to lift the more helpless children, accompany each stag(\ 
In stages owned by the city the attendants are men. The stage- 
provided by the Association for the Aid of Crippled Children are ac- 
companied b}' women nurses as attendants. The special teacher iu 
charge of physically handicapped children urges the superiority of 
women attendants.^ She advocates the use of these stages m taking 
crippled children from their homes to hospitals for dispensary 
treatment. 

Lunches. — Hot lunches are sold to the cliildren for very small sums. 
In Public School 107, for example, soup was served in 1912-13 for 3 
cents, and sandwiches, cookies, cups of cocoa, etc., for 1 cent each. 
Children are rec{uired to take the soup before they are allowed to 
have sweets. In some schools, the children in the special classes for 
cripples are served fii-st. 

Physical supervision. — A special teacher is assigned to the classes 
for cripples by the director of physical training in the New York 
pubUc schools. Under her supervision the grade teachers have 
learned to watch carefully the health of the pupils. The course of 
study and physical activities of each child are limited in accordance 
with the recommendations of hospital record cards, printed in full in 
the Appendix, pages 49-51. These cards show which exercises are re- 
garded by the child's surgeon as desirable and what kinds of exer- 
cises the child in question must not undertake. The card index also 
shows whether or not the child should be allowed to climb the stairs. 
These cards are renewed once each year for all pupils under hospital 
supervision and once each term for all cases with tuberculous joints. 
They are also renewed after any long absence from school, after any 
change in a child's brace or cast, and after any surgical operation. 
Every effort is made to keep the child's record on these hospital cards 
up to date. 

Classes for different types. — Particularly good work has been done 
in the physical supervision of the children witlnn the last two years, 
since the segregation of three types of crippled children into different 
classes in all of the schools having several classes for cripples. There 
are separate classes for children with tuberculous joints in six dif- 
ferent public schools. According to the report for 1915-16, the 
formation of these classes has been followed by very beneficial 
results. Such classes are located in large rooms with southern ex- 
posu^-e and open-window ventilation with a temperature in winter 
kept between 50° and 60°. In addition to hot lunches at noon, 

' Kept, of Supt. of Schools, New York, 1914-15, p. 121. 



36 PUBLIC SCHOOL classes for CEIPPLED CHILDEEN". 

these children have special feeding both in the morning and just 
hoforc starting for home at the close of the school day. Cots and 
blankets arc provided for use during a rest period after the midday 
meal. 

Still more recently an effort has been made in the New York 
schools to segregate children who are both mentally deficient and 
physically crippled. During the year 1915-16 there were three such 
classes. The special supervisor of cripples' classes recommends that 
these segregated classes for doubly handicapped children be retained 
in the public schools, but that those children who prove themselves 
unable to benefit at all by the educational facilities provided should 
after reasonable trial be sent to an institution under the supervision 
of the department of education. 

The remaining classes in the New York schools where segregation 
into different types of classes has been begun are those for nontuber- 
culous crippled children who are mentally sound. These represent 
the majority of the crippled children. Most of them through the 
skillful orthopedic treatment of surgeons at the hospitals are eventu- 
ally fit to be transferred to regular classes in elementary schools and 
to attend high schools later. 

Visiting teachers. — There are some crippled children living at home 
who are not able to attend school even with the special facilities 
provided for cripples' classes. The New York report for 1915-16 
recommends the appointment of special visiting teachers for crippled 
children who will be assigned to the instruction of children in their 
own homes. Funds are being solicited by the Association of Public 
School Teachers of New York to pay one or two visiting teachers at 
once, before the board of education is ready to act. 

It is only a city like New York, with a very large population, 
which will find necessary large numbers of classes for crippled chil- 
dren. It is, of course, in such a city that the work can be carried on 
with the greatest degree of segregation of the children into classes of 
different types. In order to secure the benefits which undoubtedly 
come from the separation of different types of cripples into classes 
of their own, the cripples' classes are so arranged that there are, if 
possible, at least two special classes for cripples in a given building. 
The presence of two or three classes in the same building usually 
makes possible also some separation of the grades, so that one teacher 
does not have to carry six or eight grades, as she does in every special 
class for cripples if it is the only one in the building. 

Sessions. — Sessions are one hour shorter in classes for crippled 
children than in other public-school classes in New York City. The 
classes for cripples begin at 9 o'clock and end at 2 o'clock instead 
of 3. In one school where there was much congestion in the crippled 
children's classes, part-time classes were tried as an experiment. 



PUBLIC SCHOOL CLASSES FOR CEIPPLED CHILDREN. 37 

Half the children came from 8.30 to 12.30, the others from 12.30 to 
4.30, using the same stage. But the plan did not work. The 
children in the first group had to eat breaakfast at home too early; 
the children in the second group had to eat lunch at home too early. 
Also, the special seats when adjusted to fit the children in the first 
group did not fit the children in the second group. Furthermore, 
the children did not cover so much ground in their studies b}^ a \\ ide 
margin, although the new system offered apparently a school day 
but one hour shorter than the usual period from 9 to 2. The chil- 
dren were actually able to accomplish much less because of the 
liberal rest periods needed by manj^ of them. 

Curriculum. — The curriculum is as closely similar as possible to 
that in classes for children who are not crippled. The classes are 
not graded quite so exactly; the children are given more individual 
attention and more time is spent on handwork. 

IlandworTc. — There is great variation between the classes for crip- 
ples in different schools in regard to the amount of time given to 
handwork and simple industrial processes. Most of the classes offer 
all the usual kindergarten handwork and more advanced work with 
cloth, raffia, and yarn. It is noteworthy that the superintendents 
of the schools where least provision is made for such teaching urge 
the undertaking of more handwork.^ 

No public Jiigli school nor trade scZiooZ.-^There is no high school with 
special facilities for cripples, and no public trade school. Trade 
classes for girls in needlework of many kinds and for boys in box 
making are maintained privately at the Crippled Children's East 
Side Free School; also other trade classes at two other private 
schools, the Rhinelander School, distinguished for its classes in 
jewelry, and the William. H. Davis Free School, notable for hand- 
made articles of leather and wood, as well as needlework. 

CHICAGO. 

The city of Chicago maintains special classes for crippled children 
in two sections of the city, with an average daily membership for 
1915-16 of 304.1 and an average daily attendance of 280.9. 

THE SPALDING SCHOOL. 

Building. — The Spalding School, at 1623 Park Avenue, on the west 
side of Chicago, is the only permanent school building in the United 
States built and maintained entirely by a city board of education for 
the exclusive use of crippled children.^ It is a one-story and attic 
building only shghtly elevated above the street. On the ground 

1 See Kept, of Supt. of Schools, New York, 1915-16, pp. 78, 80, 81. 

2 The school building for cripples in Cleveland serves its purpose very w ell, but is of a much less perma- 
nent character, since it is built entirely of wood. 



38 PUBLIC SCHOOL CLASSES FOE CRIPPLED CHILDEEN". 

floor there are five classrooms and an assembly hall, a kitchen, a 
dining room, and a nurse's room, batliroom, and rest room. The 
attic, which is reached by an incline from the first floor, contains the 
industrial classrooms. The children in the attic rooms are pro- 
tected against accident in case of fire by a specially designed firo 
escape recently completed. An incline 100 feet long leads from each 
end of the attic directly to the ground. Twice as many children are 
now taught in this building as it was designed to accommodate, 
because of the rotary system which changes the children about from 
class work to industrial work, etc. An addition to the building has 
been authorized by the board of education to cost $82,000. It will 
contain four additional classrooms, three large industrial rooms, an 
assembly hall with a stage, nurse's room, dental room, masseur's 
room, rest room, receiving room, toilets, bathroom, and a large sun 
room with glass roof. 

The equipment of this school is of the most modern sort obtainable. 
Special seats and desks axe provided, also a liberal number of wheel 
chairs. Cork matting is laid on the hall floors. 

Pupils and teachers.— The enrollment m this school for the year 
1915-16 was 225, of whom 200 were taught in the building itself, and 
25 were patients confined to their beds in the nearby Home for Des- 
titute Crippled Children. One teacher is assigned to give bedside 
instruction to these children. In 1916-17, 200 were taught in the 
Spalding School, 25 at the hospital, and 85 in temporary quarters in 
the wmg of a neighboring school building. In 1916-17, 11 teachers 
were employed for regular class work, 2 teachers for industrial work, 
and 2 for corrective gymnastics. 

Transportation. — The entire expense is borne by the city of Chicago. 
Since January, 1917, each of the teachers has been paid $200 more 
than the amount paid teachers for similar work in other pubhc schools. 
The children are taken to and from school in comfortably heated and 
ventilated motor busses, which replaced the old horse busses in 1914. 
Each bus has in addition to the driver a man or woman attendant. 
These motor busses have made it possible to enlarge the school dis- 
trict, and some of the children come from long distances. Hot 
lunches are furnished at noon and milk to drink upon the arrival of 
the children in the morning. 

Physical supervision. — The schools for cripples in Chicago have 
always emphasized strongly the physical care of the children. This 
is especially true of the larger of the two schools, the Spalding School. 
The principal of this school states in her report for 1915-16: 

The policy of the school is to take in all crippled children who apply, even though 
the deformity may be very slight, so that ad^'ice and assistance may be given parents 
in obtaining proper treatment. The first aim of the school is to improve the physical 
condition of the children. The actual school work gives place always to this. 



PUBLIC SCHOOL CLASSES FOR CEIPPLED CHILDREN. 39 

The teachers in the school are required by the board of education 
to take a special course of study concerning the diseases, treatment, 
and care of crippled children, and a course in industrial work suited 
to cripples. They are able to cooj>crate intelligently with the sj>eciai 
teachers who give curative gymnastics to the children. 

The entire care of the physical condition of the children has boon 
taken over by the new Municipal Tuberculosis Sanitarium of Chi- 
cago, which has enlarged its field in order to care for all the crippled 
children whether or not the cause of their condition is bone tubercu- 
losis. The sanitarium furnishes to the school a nurse and medical 
supplies, arranges for operations and treatment, and takes the 
children to clinics. Complete files arc kept in which there is a social 
and physical history of each child. At the Spalding School itself, 
the children have thorough ph3^sical examinations frequently, daily 
dressing of sinuses, massage, and curative gymnastics, and baths for 
medical purposes. The board of education has recently installed 
dental equipment at a cost of $500, and the board of health gives the 
services of a dentist. An oculist from the board of health also visits 
the school. 

Sessions. — ^This school is in session from 9 until 2 during the school 
year. A morning session has sometimes been held in summer. 
Every child from this school has the opportunity to spend six weeks 
in a private summer camp in Wisconsin. 

Curriculum. — The regular course of study outhned for the eight 
grades of the elementary schools in Cliicago is used as a basis for the 
curriculum. The board of education authorized the opening of a 
high-school department for crippled children in connection with the 
Spalding School. The first class of cripples doing work in high-school 
subjects was opened in September, 1916, with nine pupils. 

Handwork and industrial classes. — A large amount of handwork has 
always been done at the Spalding School in Chicago, and since January 
1, 1916, special attention has been given to industrial work. At that 
time new equipment was added and new courses offered. The 
children in the fourth and fifth grades have a total of 1 hour and 50 
minutes of work in the shop each week. Those in the sixth, seventh, 
and eighth grades have 75 minutes daily in industrial classes. The 
younger children have made toys and doll furniture after completing 
tho regular kindergarten processes of cutting paper, weaving, etc. 
Older children have manual training work, sewing, crocheting, lace 
making, basketry, cooking, printing, block printing, cobbling, weav- 
ing, special training in designing and free-hand lettering, making of 
artiticial flowers, t3^pewriting, and bookkeeping. For a detailed 
account of work in different hand processes, see pages 31-33 of this 
bullciin. 



40 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN, 

THE FALLON SCHOOL. 

The large Fallon School, on the south side of Chicago, has many 
classrooms for normal children and has also reserved on the first floor 
for the exclusive use of crippled children four classrooms and a play 
room, a kitchen, dining room, and toilet rooms. Four grade teachers 
give their entire time to the crippled children. In 1915-16, the 
enrollment was 89, and the average attendance was about 84. In 
November, 1917, there were 94 children registered, and the average 
attendance was 90. 

All expenses in these classes arc met by the city. The teachers 
receive a bonus of $200. Motor busses are used to transport the 
children. Hot lunches are provided at noon, and milk or cocoa to 
drink in the morning. Desks and seats adjustable as to height are 
provided. 

Physical supervision. — A nurse from the Municipal Tuberculosis 
Sanitarium is in constant daily attendance, dressing sinuses, taking 
temperatures, etc. A doctor from the same institution comes daily 
to inspect the children. A special teacher of corrective gymnastics 
is employed, who gives daily exercises with very beneficial results. 
A masseur gives massage two days each week to children whose 
parents grant permission for such treatment. One of the teachers in 
this school has used songs and rhythmic motion, with music as an 
accompaniment, in order to make the children more spontaneous in 
their activity, and has secured excellent results in stretching and 
strengthening muscles by means of dancing. 

Organization. — The school sessions last from 9 until 2 during the 
winter, and summer sessions have been held from 9 until 12 in the 
morning. Many of the children go to a private camp in summer. 
The curriculum is similar to that in other public-school classes, except 
for the increased emphasis upon handwork. All the ordinary proc- 
esses with paper, raffia, reed, and cloth are taught. 

PHILADELPfflA. 

The city of Philadelphia has set apart seven special rooms for 
crippled children in three of the large public schools in different parts 
of the city. Seven teachers are employed for these classes. Another 
teacher, paid by the city, is assigned for work with crippled children 
at the Orthopedic Hospital. The average number of children en- 
rolled for the year 1915-16 was 140 and the average attendance was 
126.^ From 20 to 25 children are usually enrolled with each teacher, 
and an average attendance of about 18 per teacher is maintained. 

Two of the three school buildings in which special classes for cripples 
are located are less well adapted for this work than any newer school 

' For the school year 1916-17, there were eight classes for crippled children, with an average enrollment 
of 162 and an average attendance ofl42. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CniLDREN. 41 

buildings would be. The three classrooms at one of the schools and 
two classrooms at the other have each but two windows in one direc- 
tion. At the Binney annex of the McCall School, where there are 
three classes, the rooms are so dark that the gas lights are often kept 
burning at midday. The fundamental needs of fresh air and sunshine 
can not be met in such rooms. The equipment provided is in every 
other respect adequate. There are special adjustable scats in all the 
schoolrooms, and wheel chairs in which the children sometimes rest. 
Kitchens, dining rooms, and separate toilet rooms for the cripples 
are provided. All the classrooms for cripples are on the first floor 
and have no threshholds. 

Transportation. — The children are transported to and from school 
in horse-drawn busses contracted for by the city. They are heated 
in cold weather. Each bus starts its trip at 7.30 and reaches the 
school between 8.45 and 9 o'clock. Each bus has an attendant, 
usually a man, in addition to the driver. One of the busses running 
to the Meade School has a woman attendant. When the children are 
too heavy for her, the driver carries them into the school. 

Lunches. — ^At each of the three schools a matron is employed by 
the city to assist in looldng after the phj^sical needs of the children, 
and especially to serve their noonday meal and midmorning lunch. 
The children who can afford it are allowed to make some payment 
for their meals, but most of the cost is met by subscriptions from 
philanthropic agencies and interested individuals. Just before 
Thanksgiving each year contributions of cereals and other food sup- 
plies for the benefit of these cripples' classes are taken up in the 
various schools in each neighborhood where the classes for cripples 
are located. 

Physical supervision. — The orthopedic supervision is- entirely 
through the hospitals of Philadelphia. The teachers cooperate with 
visiting nurses from the hospitals. The school nurse has general 
supervision of the cripples, as of other children, and a matron is pro- 
vided in each school where there are cripples, to superintend the 
serving of their lunches and to act as attendant when needed. 

Curriculum. — The school work is based upon that of the regular 
elementary grades, with the addition of a large amount of handwork. 
The smaller children work with paper, reed, and beads. At the 
Meade School eight children are doing good work in rug weaving on 
the one loom which has been thus far provided. Two looms could 
probably be kept busy. The older children in this school have also 
made creditable hammocks. 

Segregation. — At the McCall School, one of the three rooms 
assigned to cripples is given to children of the fu'st and second grades 
who are mentally normal. Another room has children from the third 
grade up who are of good mentaUty. The third room has only child- 



42 PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDEEN". 

reii of the lower grades and includes those who are mentally dull or 
actually defective. The teacher of this class has been specially 
trained for the instruction of mentally retarded pupils. 

At the Meade School^ each of the two classrooms for cripples has 
some beginners, but most of the children in one of the rooms are 
included in the first three grades. 

In the second room some children are doing fifth-grade work. 
About 8 or 9 of the 45 children in these two classes are somewhat 
retarded mentally. If the number of classes for cripples should 
increase at this school, these children would be placed in a separate 
class as they are at the McCall School. 

CLEVELAND. 

Building and equifment, — In Cleveland, classes for crippled children 
are conducted in a one-story wooden building located in a large yard 
at the rear of the Wilson School, one of the best publie schools in the 
city. The building set aside for cripples has classrooms, dining room 
and kitchen, and surgical dressing room. Desks and seats are ad- 
justable as to height; one central pivot supports both a desk and a 
seat. Small chairs are used in the kindei'garten. 

Statistics. — The number of crippled children enrolled during the 
year 1915-16 was 127, including 17 in the kindergarten; the aver- 
age monthly enrollment was 95.7 and the average daily attendance 
87.5. There are six teachers, with an average of about 22 pupils per 
teacher. The school is financed entirely by the board of educa- 
tion. A principal and six other teachers, including a kindergartner, 
are employed. They do not receive extra pay for teaching crippled 
children. Hot lunches are furnished without cost to the children. 

Transportation and lunches. — Horse-drawn busses are supplied by 
the city for the transportation of the children. Each bus has a driver 
and a guard or attendant, who assists the children who meed help. 

Physical supervision. — The school nurse inspects the children and 
visits their homes. For actual orthopedic care most of the children 
go to the dispensary at Lakeside Hospital. An orthopedic visiting 
nurse, employed by both this hospital and Rainbow Cottage, a 
country convalescent hospital, visits the homes of many pupils at 
this school, although she does not come to the school itself. 

Sessions and curriculum. — ^^Sessions are from 9.30 to 3. Tlie work 
in this school, to quote from a letter from the assistant superin- 
tendent of schools of Cleveland — 

is about the same as we are doing in other schools: Reading, spelling, writing, arith- 
metic, geography, history, seiviiig, drawing, molding simple objects, kindergarten 
work, music, and gjTunastics. Our aim is to make these children feel that they aje 
doing what children ordinarily do, and li\ing the natural life. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 43 

I'hc liandwork includes sewing instruction to a point where the 
girls are able to make dresses for themselves, basketry, some weav- 
ing, and the making of simple toys and pottery. 

A census of all cripples in Cleveland has been made recently with 
a view to discovering in what occupations they can best earn their 
hving. 

DETROIT. 

The city of Detroit employs two teachers for special classes for 
crippled children, held in rooms on a lower floor of the Clinton School. 
The building was remodeled in 1910 in order to provide special rest 
rooms and lavatories, a kitchen and a dining room for the crippled 
children. The board of education has recently purchased a site for a 
separate building for the crippled children. 

The total number of different children enrolled for 1915-16 was 76, 
with 67 as the highest number on the roll at one time during the year. 
There are three teachers, and the number of pupils per teacher is not 
often more than 23. Each teacher of crippled children is paid $200 
a year more than a teacher doing similar work with children who are 
not crippled. 

Transportation and lunches. — Transportation is furnished by the 
city. Carriages were used at first, but in 1914-15 a new system was 
adopted. Since that time the children have been taken to and from 
school in the police patrols. The report of the superintendent of 
schools of Detroit for 1914-15 (p. 134) states that, "The children 
enjoy a much faster and safer trip. " The patrolmen serve as attend- 
ants, and the superintendent says in the same report that they "have 
been untiring in their efforts to make the trip as comfortable and 
pleasant as possible." Free hot lunches are served at noon and 
crackers and milk in the middle of the morning. 

Medical supervision. — An orthopedic surgeon, appointed by the 
board of health, examines all children applying for admission to the 
classes for cripples, and visits the school at intervals to examine the 
pupils and perform small operations. The school nurse gives massage 
and electric treatments. The Detroit Association for the Aid of Sick 
and Crippled Children supplies crutches and braces to all pupils in 
need of such help. 

Sessions. — The hours of the sessions are identical with those in other 
public school classes in the spring and fall; but from November until 
April, the classes for cripples begin an hour later in the morning, so 
that the children need not leave their homes so early in cold weather. 

Curriculum. — The curriculum has a surprisingly close resemblance 
to that for perfectly sound children. There is more attention paid 
to handwork, to which all of the children give at least half an hour 
every day. In addition to the usual hand processes with paper and 



44 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN". 



rafTia, creditable work has been done by some of the older children 
in knitting, crocheting, and rug making. In 1915-16, one of the 
teachers taught a millinery class for girls. Several of the older boys 
have gone for one day each week to another public school building 
for a special course in manual training. 

No high school for criiJi^les. — For the first time since these special 
classes were formed, the work of the eighth grade was completed by 
two crippled children during the school year of 1914-15. They could 
not go to high school because none of the high schools in Detroit 
offered the special facilities needed by these children. The director 
of the school, in her report for the year 1915-16, states: 

We earnestly hope that in the event of our having a new building, we may be 
able to establish a trade school where these older pupils may learn a trade by which 
they can support themselves in later years, 

BALTIMORE. 

The city of Baltimore maintains two classes for crippled children 
in two different public school buildings. The city also supports a 
class for cripples at each of the three private institutions for crippled 
children in or near Baltimiore, the Kernan Hospital and Industrial 
School for Crippled Children, the Children's Hospital School, and 
the Johns Hopkins Hospital School and Convalescent Home for 
Crippled Children (colored). 

The numbers of pupils and teachers appear in tabular form as 
fcUows, in the report of the board of school commissioners of Balti- 
more for the school year ending June 30, 1916: 

Teaclws and pupils in the schools for cripples at Baltimore, 1915-16. 



Schools. 







Average 


Average 




Number 


Number 


number 


attend- 


Per cent 


of 


of 


of pupils 


ance 


attend- 


classes. 


teachers. 


belong- 
ing. 


for 
1915-16. 


ance. 






15 


14 


93 






16 


14 


88 






13 


12 


92 






10 


9 


90 






14 


13 


93 



Number 
belonging, 
including 
temporary 

with- 
drawals. 



SchoolNo. 20 

School No. 22 

Kernan Hospital school 

Children's liospital school 

Johns Hopkins Hospital school 



The two classes of public school buildings have sessions from 9 
a. m. to 2 p. m. The city furnishes a light lunch at 10.30 and a more 
hearty midday meal. The children are transported between th^ir 
homes and the school buildings by automobile patrols furnished by 
the board of police commissioners, but marked "School Ambulance." 

The children range in age from 6 to 13. Most of them do work in 
one of the first four grades, with practically the same curriculum as 
that used for children in regular school classes, except that more 
handwork is done, including basketry and weaving. 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN". 45 

The grade classes taught by pubUc-school teachers at the three 
institutions cover about the ^ame ground as those in the pubhc 
school buildings, but the handwork has been further developed at 
the institutions. At the Kernan Hospital school a special teacher of 
handwork and industrial handicraft is employed by the institution. 
Good work is done in sewing, lace making, rug weaving, basketr}', 
chair caning, burnt-wood work, stenography, and typewriting. At 
the Children's Hospital school a teacher from the Playground Asso- 
ciation, half of whose salary is assumed by the hospital school, 
teaches advanced kindergarten work, basketry, and chair carting. 

PRIVATE DAY SCHOOLS FOR CRIPPLES. 

An account of pubhc school classes for crippled children in the 
United States should also include mention of one school whose work 
is semiprivate, and three which are entirely private, because these 
schools were pioneers in the development of special educational 
work for crippled children before any regular public school classes 
were opened. 

The Industrial School for Crippled and Deformed Children, in 
Boston, has done work of the highest order in the education of 
crippled children, both in grade branches and in industrial classes. 
The building was specially constructed for this purpose. It is 
modern in every particular and has all the ecjuipment needed for 
the safety and comfort of crippled children. Its classrooms contain 
100 desks and seats of the special adjustable sort. Each desk is 
adjusted at the beginning of the 3^ear, under the supervision of the 
doctor in charge, for the particular child who is to use it. The 
caj)acity of the school has recently been increased by the erection 
of a building for use as an outdoor classroom, which is a model 
structure for its purpose. 

The ecjuipment, which is equal to that in the best pubhc schools, 
includes slate blackboards, maps, kindergarten materials, shop sup- 
plies, and machines for industrial classes. The curriculum closely 
resembles that of graded public schools, and many observers of this 
school believe that its teaching standard is above that in most public 
schools. Much instruction in handwork is given, including clay 
modeling, basket making and cane seating, sloyd, needlework, cob- 
bling, cooking, typesetting, and printing. There are also special 
trade classes for cripples over 15 years of age, who give their entire 
time to the work. The subjects offered at present are needlework, 
proof reading, printing, basketry, and chair caning. 

The children are transported in busses, and free meals are pro- 
vided at noon, as well as lunches in the middle of the morning. A 
nurse is in constant attendance at the school and visits the homes 
of the children on Saturday's and during the summer months. Visit- 



46 PUBLIC SCHOOL CLASSES POE CRIPPLED CHILDBEN". 

ing physicians watch over the physical condition of the children and 
the nurse carries out their instructions, seeing, also, that the children 
go frequently to the various orthopedic dispensaries at which they 
are being treated. This school has a long waiting list and consid- 
erable time occasionally elapses before a vacancy permits admission 
of new applicants. 

The Crippled Children's East Side Free School, of New York, is a 
private organization, owning its land and building. The school 
formerly financed all phases of its work, but the grade teachmg is 
now supported by the city board of education, which furnishes the 
school equipment and pays the teachers. The classrooms accom- 
modate about 200 children and the number registered is never below 
the full capacity. There are 163 desks and chairs of the special 
adjustable variety, and 33 kindergarten chairs. All grades, from 
the kindergarten through the eighth grade, are included. Classes 
arc held on regular public school days from 9 until 2.30. The teach- 
mg very much resembles that in other pubhc schools. 

The private organization maintains the handwork and industrial 
classes, and a workroom for adult cripples where needle crafts of 
all sorts are carried on. Thirty-six girls and women earn from S3 
to S15 per week in this workroom. The school has recently begun 
a very promising experiment in the teaching of box making as a 
trade for boys. 

The private organization also supervises closely the physical 
health of all children in the buildmg. It is worthy of note that the 
windows are kept open, and the air is good at all seasons of the 
year. A visiting orthopedic surgeon holds weekly clinics at the 
school. An assistant surgeon and a trained nurse assist in the ad- 
justment of braces, application of plaster dressings, and other treat- 
ments. For more important operations the children are sent to 
various hospitals. Under the supervision of a staff of nurse maids, 
all the children have baths at the school twice each week. There 
were 9,703 baths recorded for one school year, and 450 visits were 
paid to the homes of the children. A summer home at Oakhurst, 
N. J., houses about 120 children at a time during July and August. 
Each child's stay varies from two to eight weeks. 

The Rhinelander Industrial School for Crippled Children, in New 
York, represents a combination of private activities. The New York 
Children's Aid Society furnishes the building and pays the teachers 
of grade classes. The Brearly League maintains industrial classes. 
Busses are provided by another private gift. 

The building is somewhat old-fashioned and has no elevator. For 
this reason the classes are arranged on a unique basis. The children 
able to climb stairs easily are assigned to the second floor ; the others 
remain on the first floor. The two grade classrooms are much like 



PUBLIC SCHOOL CLASSES FOR CRIPPLED CHILDREN. 47 

country schools; each includes work in all the eight grades. Regular 
class work lasts from 9 until 12 on the five school days each week. 

Jn the industrial classes the girls learn all kinds of needlework, in- 
cluding fancy stitches. The distinctive feature of the school is its 
jewelry class for boys, taught V>y an expert jeweler from a high-grade 
shop. The boys work on a two years' apprenticeship basis. They 
pay no tuition and receive no pay, except for occasional pieces made 
to order outside of the short hours of the trade class, from 9 to 3. 
The boys are taught both the making by hand of artistic pieces and 
the machine processes which they need to know in order to secure 
positions in a regular commercial jewelry shop. 

The William H. Davis Free Industrial School for Ci^lppled Children, 
in New York, is a private charity, offering kindergarten and grade 
instruction under two teachers. A wagonette, with driver and nurse, 
transports the children. They are at the school from 9 to 4 and 
receive a free hot meal at noon. The girls are taught needlework, 
including the making of many fancy articles. A few of the older 
boys, with a former pupil of the school as teacher, have designed and 
made artistic pieces in carved wood and tooled leather. The school 
has a summer home at Claverack, N. Y. 



APPENDIX A. 



SUGGESTIONS TO TEACHERS IN SMALL CITIES AND IN COUNTRY 

SCHOOLS. 

The number of crippled children is fortunately email in proportion to the total 
number of children going to school in any community, and separate classes for cripples 
are possible only in fair-sized cities. Not many towns with a population lees than 
10,000 have need of a special class for cripples, unless the town has a hospital which 
takes orthopedic cases. Nearly every town has some cripples, however, and anything 
that the individual teacher can do to induce such children to come to school and to 
make their time in school comfortable and profitable is a real contribution. 

The following are some of the practical ways in which any grade-school teacher can 
make it easier for the one or more crippled children who may attend her class. In the 
first place, she can arrange to give such children a shorter school day by letting them go 
home half an hour or an hour earlier than the other pupils. If the school has classrooms 
on more than one floor, the principal should assign to rooms on the first floor all crip- 
pled children who can not climb stairs safely. 

The teacher should give to each crij^pled child a seat not attached to the floor, 
especially if the child wears a brace. It is usually easier for a child wearing any 
apparatus to take a comfortable position if his seat is movable. If some particular 
child is badly crippled, a teacher can sometimes induce the board of education to 
purchase an adjustable seat, or charitable people in the town can be persuaded to 
buy a wheel chair for him. If the school has any couch or cot, a crippled child may 
benefit by brief rest periods spent lying down. 

It is usually not difficult to arrange for the child to bring his lunch to school. If 
the child's parents are poor, the teacher can often in some quiet way secure a gift 
wlaich will make it possible to provide milk or other nourishing food as an addition 
to the child's lunch. If the child can not walk, perhaps the teacher can persuade a 
neighbor boy to bring the cripple in his express wagon or some tradesman who 
drives by the child's home may be willing to take him along. 

If the teacher will permit a crippled child to do a large amount of handwork, she 
will find his interest unflagging. A child who can not run or jump is often unusually 
skillful with his hands. 

Many of these suggestions do not concern the duties for whose discharge a teacher 
is commonly engaged, but most teachers do not stop with the letter of their agreements. 
The greatest service that can be rendered by an intelligent and sympathetic teacher 
to the occasional crippled child in her class is one that can not be easily tabulated. 
Her fxiendly interest will keep up his courage, especially during periods of illness. 
Her championship may prevent other boys from calling the cripple names and 
treating him with thoughtless cruelty. If the teacher can possibly find time to become 
well acquainted with the crippled child's mother and visit his home frequently, she 
can often help his physical cure by suggesting open windows, by advising more whole- 
Bome food, and by urging early hours for going to bed. There is scarcely any limit 
to the influence a teacher may exercise upon the development toward useful citizen- 
ship of a crippled child who might otherwise grow up dependent upon his family or 
upon charity. 
4S 



APPENDIX B. 



RECORD CARDS USED IN NEW YORK. 

Hospital record cards. — When the department of physical training first took charge 
of the physical welfare of crippled children it was found necessary to have some official 
record whereby the school life of these children might be regulated according to the 
plan of treatment required by the orthopedic surgeon of each child. This has proved 
to be the essential basis for all recommendations for the kind and amount of both 
physical and mental work the child can do. 

Department of Education — City of New York. 

RECORD CARD FOR CRIPPLED CHILDREN. 



Name Born 

Family. Given. 

Address No Street Floor . 

Name of teacher 

School Borough Dateentered Class.. 

RECOMMENDATIONS FOR PHYSICAL TRAINING. 

I For improving posture 
For alert response — control , 
For physiological results , 

I Scat games 
Quiet games , 
Active playground games 



Exercises contraindicated. 
Name of pupil 



Family. Given. 

Hospital Physician 

Diagnosis Date 

Treatment— Mechanical appliances 

Should the child be in hospital ? 

If not, is . -he physically able to attend school ? 

Should ..he be placed in a class with physically normal children? 

Is the disease active at present ? Date 

Should . .he be permitted to climb stairs ? No. flights 

Chorea Card iac disease Vision Breathing Hearing. 



Class record of physical welfare of crippled children. — ^This card was originated for tlie 
use of the class teacher in order that the medical record on the hospital card might be 
transcribed in terms applicable to schoolroom activities. The physical and mental 
effort of each pupil is governed by the diagnosis and recommendations on the card. 
The physical -welfare card was tried by way of experiment last year with success. The 
principals find it helpful as a reliable record of the children in their classes for cripples, 
and in the opinion of one of the principals who have had the greatest experience 
with those classes, it is one of the best record cards for such purpose now in use. 
46486°— 18 4 49 



60 



PUBLIC SCHOOL CLASSES EOR CRIPPLED CHILDREN. 

Department of Education. 

P.S Boro 



Form P t 2. 



THE CITY OF NEW YORK. 

[Class record of physical welfare of crippled children.] 



.Teacher. 





5 


<1 


Formal exercises. 


Recreative 
exercises. 





ft 

g 




Names of pupils 
(boys). 






o 


■3 


tea 


B 
a 
be 

m 


a 





-a 

a 

w>a 


Remarks. 























































































































































































































































































































































































































































































































































Date. 



.Department ofPfiyskal Training. 



Large record cards for crippled children. — In the supervision of the physical welfare 
of crippled children much valuable and helpful data concerning them has been 
obtained. In order that this may be kept systematically for the benefit of each child, 
the large physical record card of the department of physical training was originated. 
The records on this card are entered entirely by this department and filed at the ofl3.ce 
for reference. 



PUBLIC SCHOOL CLASSES FOR CEIPPLED CHILDREN". 



51 




APPENDIX C. 



COST OF SPECIAL CLASSES IN CHICAGO AND CLEVELAND. 

CHICAGO. 

Expenditures for public-school classes for cripples.^ 

Teachers' salaries $14,905.00 

Educational supplies ; 306. 45 

Lunches 2, 300. 00 

Transportation 24, 930. 00 

40, 441. 45 

Per capita cost: 

Teachers' salaries 51. 24 

Educational supplies .16 

Lunches 7. 96 

Transportation ■ 86. 26 

145. 56 

CLEVELAND. 

Expenditures for public-school classes for cripples for three successive school years? 



Year. 


Cost of 
instruc- 
tion. 


Enroll- 
ment. 


Per capita 

cost of 
instruction. 


1913-14 


S5,262.84 
5,644.38 
5, 588. 89 


117 
115 
127 


S44.98 


1914-15 


49.08 


1915-16 


3 44. 00 







1 See Report of Superintendent of Schools for 1915-16, p. 80. 

2 Idem, pp. 57, 149. 

3 Per capita cost for 1915-16 when reckoned on average monthly enrollment instead of on registration 
was $58.40 instead of $44. 



52 



o 



BULLETIN OF THE BUREAU OF EDUCATION. 

[Continued from page 2 of cover.] 

1917. 

No. 33. A comparison of the salaries of rural and urban superintendents of 

schools. A. C. Monahan and 0. H. Dye. 
No. 34. Institutions in the United States giving Instruction in agriculture. 

A. C. Monahan and C, H. Dye. 
No. 35. The township and community high-school movement In Illinois. H. A. 

Hollister. 
No. 36. Demand for vocational education in the countries at war. Anna T. 

Smith. 
No. 37. The conference on training for foreign service. Glen L. Swiggett. 
No. 38. Vocational teachers for secondary schools. C. D. Jarvis. 
No. 39. Teaching English to aliens. Winthrop Talbot. 

No. 40. Monthly record of current educational publications, Septembei', 1917. 
No. 41. Library books foe high schools. Mai'tha >Vilson. 
No. 42. Monthly record of current e<:lucatioual publications, October, 1917. 
No. 43. Educational directory, 1917-18. 
No. 44. Educational conditions in Arizona. 
No. 45. Summer sessions in city schools. W. S. Deffenbaugh. 
No. 46. The public school system of San Francisco, Cal. 
No. 47. The preparation and preservation of vegetables. Henrietta W. Calvin 

and Carrie A. Lyford. 
No. 48. Monthly record of current educational publications, November, 1917. 
No. 49. Music in secondary schools. A report of the Commission on Secondary 

Education. Will Earhart and Osbourne McConathy. 
No. 50. Physical education in secondary schools. A report of the Commission 

on Secondary Education. 
No. 51. Moral values in secondurj education. A report of the Commission on 

Secondary Education. Henry Neumann. 
No. 52. Monthly record of current educational publications, December, 1917. 
No. 53. The conifers of the northern liockies. J. E. Kirkwood. 
No. 54. Training in courtesy. Margaret S. McNaught. 
No. 55. Statistics of State universities and State colleges, 1917. 

1918. 

No. 1. Monthly record of current educational publications, January, 1918. 
No. 2. The publications of the United States Government. W. I. Swanton. 
No. 8. Agricultural instruction in the high schools of six eustern States. C. H. 

Lane. 
No, 4. Monthly record of current educational publications, February, 1918. 
No. 5. Work of the Bureau of Education for tlie natives of Alaska, 1916-17. 
No. 6. The curriculum of the woman's college. Mabel L. Robinson. 
J^Jo. 7. The bureau of extension of the University of North Carolina. Louis 

R. Wilson and Lester A. Williams. 
No. 8. Monthly record of current educational publications. March, 1918. 
No. 9. Union list of mathematical periodicals.-, David E. Smith. 
No, 10. PuWic school classes for crippled children. Edith R. Solenberger. 
No. 11. A community center — what it is and how to organize it. Henry E. 

Jackson. 



LIBRARY OF CONGRESS 



029 942 059 



